Hook on the brain
–A story about a child with trauma
I am Chen Ruoping, Director of Pediatric Neurosurgery at Shanghai Children’s Hospital. As a professional physician practicing for more than 20 years, I have not only treated many patients, but also have many stories, some happy, some sad, and some sorry. I hope my story can provide some experience for you and avoid those heartbreaking stories as much as possible. Chen Ruoping, Department of Neurosurgery, Shanghai Children’s Hospital
One usual evening, I was resting at home when my phone rang, it was an emergency trauma patient from the hospital that needed me to come to the hospital. So, I hurried to the hospital. As a neurosurgeon, I have seen many cranio-cerebral trauma patients, but I was still surprised by the scene in front of me: a cute three-year-old boy was lying quietly on the hospital bed, but a metal hook was stuck on his head. It turned out that while the adults were paying attention to their own business, the boy slipped to the table to play, and accidentally fell off the table and hit his head on a metal hook on the wall. The adults hurriedly shoveled the hook down from the wall and sent him to the hospital in an emergency. After careful examination, it was found that the hook had penetrated the skull and entered the cranial cavity, but fortunately the hook did not pierce the eye and only slightly pierced the brain tissue, so the child was still conscious and had no symptoms of hemiplegia. Since the hook had pierced the brain tissue, simply pulling it out might not only lead to hemorrhage, but also leave behind foreign bodies and bacteria that could lead to intracranial infection, so craniotomy to remove the hook and clean and treat the wound became the only option.
After five hours of intense craniotomy, the hook was successfully pulled out, the punctured brain tissue and surrounding tissues were thoroughly cleaned, the punctured meninges were repaired, and all in all, the surgery went very well. After the surgery and anti-infection treatment, the little boy was successfully discharged from the hospital and restored to health. Although the outcome was satisfactory, it was completely avoidable.
In the following months, two other similar traumas occurred. A nine-year-old girl fell while playing with a crochet hook, resulting in the hook being inserted through the eye socket and along the base of the skull into the cranial cavity. It was also fortunate that the crochet hook did not damage the eye and only slightly damaged the brain tissue. After six hours of surgery, the crochet hook was successfully extracted.
An eight-year-old boy grabbed a classmate’s movable pencil and accidentally fell during the fleeing chase, resulting in the pencil also being inserted into the cranial cavity from the eye socket along the skull base; it was also fortunate that no serious injury occurred to the child. However, there was a mistake in its early treatment, and as a result, the head section of the movable pencil was left in the cranial cavity. After our five-hour surgery, the pencil tip left in the cranial cavity was removed, the hematoma of the brain tissue was cleared, and the damaged meninges were repaired. The child was successfully discharged from the hospital
In less than six months, we encountered three cases of children with intracranial foreign body injuries. Although very fortunate that the children recovered, it is always frightening to think of these children: Lady Luck does not always favor; these injuries could have been completely avoided.
Children are lively and active by nature, and lack sufficient and conscious awareness of the dangers around them, so both their guardians, their teachers, and society as a whole should work to avoid trauma to children. For these three children, the injury could have been completely prevented if they had not played on the table, if they had been supervised by an adult, if they had not played with sharp objects, and if they had not run with sharp objects. Trauma is the leading cause of death and disability in children before the age of 18 [1]. The annual incidence of childhood trauma can reach 200/100,000 and with the rapid increase of motor vehicles worldwide, there is a significant increase in the rate of death and disability of children due to traffic accidents, up to 21.5/10,000 vehicles in developing countries [2]. At the same time, society and families invest huge amounts of money to treat children’s trauma, with the United States spending $34.6 billion in this amount in 2000.
After listening to my story, I hope the whole society will act: protect and supervise children, nothing is more important than children; educate and train children to build safety awareness and self-protection ability. Minimize your child’s injuries.