Sub-decapitation in suicidal chainsaw injury: report of a rare case and operative management
- PDF / 616,462 Bytes
- 4 Pages / 595.276 x 790.866 pts Page_size
- 27 Downloads / 191 Views
CASE REPORT - SPINE TRAUMA
Sub-decapitation in suicidal chainsaw injury: report of a rare case and operative management P. Krauss 1
&
V. M. Butenschoen 1 & B. Meyer 1 & C. Negwer 1
Received: 8 May 2020 / Accepted: 15 May 2020 # Springer-Verlag GmbH Austria, part of Springer Nature 2020
Abstract Chainsaw accidents are severe injuries, mostly work-related and concerning upper or lower extremities. Few suicidal chainsaw injuries are reported, all of them fatal. We report the case of a 23-year-old man who attempted suicide by sub-decapitation with a chainsaw, its successful (peri-) operative management, and clinical course along with a discussion of the contemporary management and body of evidence of such lesions. Chainsaw injuries are severe traumas. Stepwise surgery with maximal functional reconstruction is safe and optimal clinical outcome can be achieved. Keywords Spine trauma . Cervical spine . Decapitation . Spine surgery . Case report
Background and importance
Clinical presentation
In Germany, ~ 10,000 people commit suicide every year, often provoked by psychiatric disorders like major depression or schizophrenia [2]. The most frequent mode of suicide is strangling. Self-injury using penetrating objects in the head/neck region or auto-decapitation is extremely rare [2]. Only few cases of suicidal decapitation by a chainsaw are reported in the literature [17, 18]. More common, but still rare, are chain saw injuries through a third person or as work accidents [6, 12], most commonly resulting in injuries of upper or lower extremities [10]. Chainsaw injuries lead to extensive soft tissue lacerations affecting blood vessels, nerves, and bony structures [3, 6, 17, 18]. Different types of chainsaws cause distinct injury patterns, which is especially relevant in forensic medicine [15]. Suicidal chainsaw injuries can result in hemorrhagic shock due to extensive blood loss or fatal cerebral hypoperfusions. In non-fatal injuries of the neck, the complex anatomy and pattern of trauma defines the surgical strategy. Here, we report the case of a 23year-old male patient with severe cervical trauma due to a suicidal chainsaw injury.
History and examination
This article is part of the Topical Collection on Spine trauma * P. Krauss [email protected] 1
Department of Neurosurgery, Klinikum rechts der Isar, Ismaninger Strasse 22, 81675 Munich, Germany
The evening before admission, the patient tried to perform suicide by auto-decapitation using a chainsaw and was found by his brother the following morning. At the site of injury, the emergency physician encountered a patient with stable circulation and a GCS of 13 without motor deficits (Fig. 1). On site intubation, cervical spine immobilization was immediately performed and the patient was transferred to the emergency department of a tertiary care hospital in southern Germany. On arrival, the patient presented in stable conditions with pupils equally round and reactive to light. The extensive cervical trauma was covered with sterile bandages without signs of further trauma
Data Loading...
