{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,4]],"date-time":"2026-02-04T15:01:25Z","timestamp":1770217285375,"version":"3.49.0"},"reference-count":66,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","issue":"11","license":[{"start":{"date-parts":[[2025,3,17]],"date-time":"2025-03-17T00:00:00Z","timestamp":1742169600000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["J Cosmet Laser Ther"],"published-print":{"date-parts":[[2025,3,17]]},"abstract":"<jats:sec>\n                    <jats:title>BACKGROUND<\/jats:title>\n                    <jats:p>Penetrating brain injuries (PBIs) are rare cases of traumatic brain injuries and are associated with high mortality. Initial management for PBIs focuses on airway, circulation, and cranial imaging evaluation. In the next step, physical examinations are essential, including understanding the mechanism of injury, conducting a thorough neurological assessment, and reviewing medications. Imaging techniques such as CT and CT angiography are essential for assessing the extent of the injury and predicting outcomes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>OBSERVATIONS<\/jats:title>\n                    <jats:p>A 30-year-old male presented with a PBI in the left eye. A CT scan revealed that a knife had penetrated into the frontal lobe, causing contusions and subarachnoid hemorrhage. Angiography showed that the knife was close to the anterior cerebral artery (A1\u2013A2 junction), which increased the risk of hemorrhage and complications during removal of the knife. A hybrid approach using angiographic guidance and balloon\/stent catheters was used. Incremental removal of the knife was performed with real-time angiographic monitoring. The patient underwent successful skull base repair and enucleation, with follow-up showing no complications.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>LESSONS<\/jats:title>\n                    <jats:p>Traditional acute management typically involves craniotomy for foreign object removal; however, this case report highlights the successful application of endovascular techniques alongside the classic method for hybrid management of these patients.<\/jats:p>\n                    <jats:p>\n                      <jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" ext-link-type=\"uri\" xlink:href=\"https:\/\/thejns.org\/doi\/10.3171\/CASE24692\">https:\/\/thejns.org\/doi\/10.3171\/CASE24692<\/jats:ext-link>\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.3171\/case24692","type":"journal-article","created":{"date-parts":[[2025,3,17]],"date-time":"2025-03-17T03:01:48Z","timestamp":1742180508000},"source":"Crossref","is-referenced-by-count":0,"title":["Hybrid endovascular and open surgical management of retained stab wounds: illustrative case"],"prefix":"10.3171","volume":"9","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9786-9954","authenticated-orcid":true,"given":"Ehsan Mohammad","family":"Hosseini","sequence":"first","affiliation":[{"name":"School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Seyed Hossein","family":"Aghamiri","sequence":"additional","affiliation":[{"name":"School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1660-3178","authenticated-orcid":true,"given":"Mohsen","family":"Koosha","sequence":"additional","affiliation":[{"name":"Neurosurgery Department, Shahid Beheshti University of Medical Sciences, Tehran, Iran"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mohammad","family":"Hasanpour","sequence":"additional","affiliation":[{"name":"Division of Vascular and Endovascular Neurosurgery, Iran University of Medical Sciences, Tehran, Iran"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0005-3616-9558","authenticated-orcid":true,"given":"MohammadAmin","family":"Farajzadeh","sequence":"additional","affiliation":[{"name":"School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran"},{"name":"School of Cognitive Sciences, Institute for Research in Fundamental Sciences (IPM), Tehran, Iran"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1754","reference":[{"issue":"6):1000336","key":"bib1","series-title":"J Neurol Neurophysiol","article-title":"Penetrating traumatic brain injury: a review of current evaluation and management concepts","volume":"6","author":"Van Wyck","year":"2015","unstructured":"Van Wyck DWGrant GA.Penetrating traumatic brain injury: a review of current evaluation and management concepts. J Neurol Neurophysiol. 2015;6(6):1000336."},{"issue":"1","key":"bib2","series-title":"J Am Coll Surg","first-page":"58","article-title":"Improving survival rates after civilian gunshot wounds to the brain","volume":"218","author":"Joseph","year":"2014","unstructured":"Joseph BAziz HPandit VImproving survival rates after civilian gunshot wounds to the brain. J Am Coll Surg. 2014;218(1):58-65."},{"issue":"2","key":"bib3","series-title":"Neurol Med Chir (Tokyo)","first-page":"150","article-title":"Transorbital-transpetrosal penetrating cerebellar injury\u2014case report","volume":"39","author":"Kitakami","year":"1999","unstructured":"Kitakami AKirikae MKuroda KOgawa A.Transorbital-transpetrosal penetrating cerebellar injury\u2014case report. Neurol Med Chir (Tokyo). 1999;39(2):150-152."},{"key":"bib4","series-title":"Acute Care Neurosurgery by Case Management: Pearls and Pitfalls","author":"Raksin","year":"2022","unstructured":"Raksin PBAcute Care Neurosurgery by Case Management: Pearls and Pitfalls. Springer International Publishing; 2022."},{"issue":"9","key":"bib5","series-title":"MMWR Surveill Summ","first-page":"1","article-title":"Traumatic brain injury\u2013related emergency department visits, hospitalizations, and deaths\u2014United States, 2007 and 2013","volume":"66","author":"Taylor","year":"2017","unstructured":"Taylor CABell JMBreiding MJXu L.Traumatic brain injury\u2013related emergency department visits, hospitalizations, and deaths\u2014United States, 2007 and 2013. MMWR Surveill Summ. 2017;66(9):1-16."},{"issue":"10","key":"bib6","series-title":"J Emerg Crit Care Med","first-page":"28","article-title":"Surgical interventions for severe traumatic brain injury","volume":"1","author":"Fong","year":"2017","unstructured":"Fong RKonakondla SSchirmer CMLacroix M.Surgical interventions for severe traumatic brain injury. J Emerg Crit Care Med. 2017;1(10):28-28."},{"issue":"3","key":"bib7","series-title":"Emerg Radiol","first-page":"301","article-title":"A review of penetrating brain trauma: epidemiology, pathophysiology, imaging assessment, complications, and treatment","volume":"24","author":"Vakil","year":"2017","unstructured":"Vakil MTSingh AK.A review of penetrating brain trauma: epidemiology, pathophysiology, imaging assessment, complications, and treatment. Emerg Radiol. 2017;24(3):301-309."},{"issue":"1","key":"bib8","series-title":"Scand J Trauma Resusc Emerg Med","first-page":"71","article-title":"The definition of major trauma using different revisions of the abbreviated injury scale","volume":"29","author":"Van Ditshuizen","year":"2021","unstructured":"Van Ditshuizen JCSewalt CAPalmer CS. The definition of major trauma using different revisions of the abbreviated injury scale. Scand J Trauma Resusc Emerg Med. 2021;29(1):71."},{"issue":"3","key":"bib9","series-title":"J Emerg Trauma Shock","first-page":"395","article-title":"Management of penetrating brain injury","volume":"4","author":"Kazim","year":"2011","unstructured":"Kazim SFShamim MSTahir MZEnam SAWaheed S.Management of penetrating brain injury. J Emerg Trauma Shock. 2011;4(3):395-402."},{"issue":"2","key":"bib10","series-title":"J Med Radiat Sci","first-page":"122","article-title":"Neuroimaging in adult penetrating brain injury: a guide for radiographers","volume":"62","author":"Temple","year":"2015","unstructured":"Temple NDonald CSkora AReed W.Neuroimaging in adult penetrating brain injury: a guide for radiographers. J Med Radiat Sci. 2015;62(2):122-131."},{"issue":"2","key":"bib11","series-title":"J Am Coll Radiol","first-page":"e1","article-title":"Imaging evidence and recommendations for traumatic brain injury: conventional neuroimaging techniques","volume":"12","author":"Wintermark","year":"2015","unstructured":"Wintermark MSanelli PCAnzai YImaging evidence and recommendations for traumatic brain injury: conventional neuroimaging techniques. J Am Coll Radiol. 2015;12(2):e1-e14."},{"issue":"1","key":"bib12","series-title":"Skull Base Rep","first-page":"39","article-title":"Management of nonmissile penetrating brain injuries: a description of three cases and review of the literature","volume":"1","author":"Sweeney","year":"2011","unstructured":"Sweeney JMLebovitz JJEller JLCoppens JRBucholz RDAbdulrauf SI.Management of nonmissile penetrating brain injuries: a description of three cases and review of the literature. Skull Base Rep. 2011;1(1):39-46."},{"issue":"9","key":"bib13","series-title":"Acta Neurochir (Wien)","first-page":"937","article-title":"Orbito-cranial injuries caused by penetrating non-missile foreign bodies. Experience with eighteen patients","volume":"148","author":"Chibbaro","year":"2006","unstructured":"Chibbaro STacconi L.Orbito-cranial injuries caused by penetrating non-missile foreign bodies. Experience with eighteen patients. Acta Neurochir (Wien). 2006;148(9):937-941."},{"issue":"6","key":"bib14","series-title":"J Trauma","first-page":"1446","article-title":"Penetrating gunshot injuries to the brain","volume":"62","author":"Kim","year":"2007","unstructured":"Kim TWLee JKMoon KSPenetrating gunshot injuries to the brain. J Trauma. 2007;62(6):1446-1451."},{"issue":"7","key":"bib15","series-title":"RadioGraphics","first-page":"2005","article-title":"Radiologic findings in cases of attempted suicide and other self-injurious behavior","volume":"32","author":"DiPoce","year":"2012","unstructured":"DiPoce JGuelfguat MDiPoce J.Radiologic findings in cases of attempted suicide and other self-injurious behavior. RadioGraphics. 2012;32(7):2005-2024."},{"key":"bib16","series-title":"World Neurosurg","first-page":"297","article-title":"Treatment of penetrating nonmissile traumatic brain injury. Case series and review of the literature","volume":"91","author":"Zyck","year":"2016","unstructured":"Zyck SToshkezi GKrishnamurthy STreatment of penetrating nonmissile traumatic brain injury. Case series and review of the literature. World Neurosurg. 2016;91:297-307."},{"issue":"5","key":"bib17","series-title":"J Neurosurg","first-page":"1275","article-title":"Vascular complications of penetrating brain injury: comparison of helical CT angiography and conventional angiography","volume":"121","author":"Bodanapally","year":"2014","unstructured":"Bodanapally UKShanmuganathan KBoscak ARVascular complications of penetrating brain injury: comparison of helical CT angiography and conventional angiography. J Neurosurg. 2014;121(5):1275-1283."},{"issue":"6","key":"bib18","series-title":"World J Surg","first-page":"1352","article-title":"Current concepts in penetrating and blast injury to the central nervous system","volume":"39","author":"Rosenfeld","year":"2015","unstructured":"Rosenfeld JVBell RSArmonda R.Current concepts in penetrating and blast injury to the central nervous system. World J Surg. 2015;39(6):1352-1362."},{"issue":"2","key":"bib19","series-title":"Clin Neurol Neurosurg","first-page":"207","article-title":"Penetrating brain injury by drill bit","volume":"110","author":"Guti\u00e9rrez-Gonz\u00e1lez","year":"2008","unstructured":"Guti\u00e9rrez-Gonz\u00e1lez RBoto GRRivero-Garv\u00eda MP\u00e9rez-Zamarr\u00f3n AG\u00f3mez G.Penetrating brain injury by drill bit. Clin Neurol Neurosurg. 2008;110(2):207-210."},{"issue":"5","key":"bib20","series-title":"Neurosurgery","first-page":"1117","article-title":"Transcranial brainstem stab injuries: a retrospective analysis of 17 patients","volume":"47","author":"Nathoo","year":"2000","unstructured":"Nathoo NBoodhoo HNadvi SSNaidoo SRGouws E.Transcranial brainstem stab injuries: a retrospective analysis of 17 patients. Neurosurgery. 2000;47(5):1117-1123."},{"issue":"1","key":"bib21","series-title":"J Neurosurg","first-page":"42","article-title":"Vascular lesions due to transcranial stab wounds","volume":"60","author":"Kieck","year":"1984","unstructured":"Kieck CFDe Villiers JC.Vascular lesions due to transcranial stab wounds. J Neurosurg. 1984;60(1):42-46."},{"key":"bib22","series-title":"Handb Clin Neurol","first-page":"447","article-title":"Imaging of head trauma","volume":"135","author":"Rincon","year":"2016","unstructured":"Rincon SGupta RPtak T.Imaging of head trauma. In: Handb Clin Neurol. Elsevier. 2016;135:447-477."},{"issue":"2","key":"bib23","series-title":"Bull Emerg Trauma","first-page":"65","article-title":"Craniocerebral gunshot injuries; a review of the current literature","volume":"4","author":"Alvis-Miranda","year":"2016","unstructured":"Alvis-Miranda HRM Rubiano AMAgrawal ACraniocerebral gunshot injuries; a review of the current literature. Bull Emerg Trauma. 2016;4(2):65-74."},{"issue":"2","key":"bib24","series-title":"Neuroimag Clin N Am","first-page":"229","article-title":"Radiographic assessment of cranial gunshot wounds","volume":"12","author":"Kim","year":"2002","unstructured":"Kim PEGo JLZee CS.Radiographic assessment of cranial gunshot wounds. Neuroimag Clin N Am. 2002;12(2):229-248."},{"issue":"3","key":"bib25","series-title":"Neurosurg Rev","first-page":"177","article-title":"Causes of infections and management results in penetrating craniocerebral injuries","volume":"20","author":"G\u00f6n\u00fcl","year":"1997","unstructured":"G\u00f6n\u00fcl EBaysefer AKahraman SCauses of infections and management results in penetrating craniocerebral injuries. Neurosurg Rev. 1997;20(3):177-181."},{"issue":"5","key":"bib26","series-title":"J Neurosurg","first-page":"1658","article-title":"Complications, outcomes, and management strategies of non-missile penetrating head injuries","volume":"134","author":"Harrington","year":"2021","unstructured":"Harrington BMGretschel ALombard CLonser RRVlok AJ.Complications, outcomes, and management strategies of non-missile penetrating head injuries. J Neurosurg. 2021;134(5):1658-1666."},{"issue":"1","key":"bib27","series-title":"Neurosurg Focus","first-page":"e1","article-title":"Prognostic factors in the occurrence of posttraumatic epilepsy after penetrating head injury suffered during military service","volume":"8","author":"Aarabi","year":"2000","unstructured":"Aarabi BTaghipour MHaghnegahdar AFarokhi MMobley L.Prognostic factors in the occurrence of posttraumatic epilepsy after penetrating head injury suffered during military service. Neurosurg Focus. 2000;8(1):e1."},{"issue":"9217","key":"bib28","series-title":"Lancet","first-page":"1813","article-title":"Use of antibiotics in penetrating craniocerebral injuries. \u201cInfection in Neurosurgery\u201d Working Party of British Society for Antimicrobial Chemotherapy","volume":"355","author":"Bayston","year":"2000","unstructured":"Bayston RDe Louvois JBrown EMJohnston RALees PPople IK.Use of antibiotics in penetrating craniocerebral injuries. \u201cInfection in Neurosurgery\u201d Working Party of British Society for Antimicrobial Chemotherapy. Lancet. 2000;355(9217):1813-1817."},{"issue":"11","key":"bib29","series-title":"Arch Phys Med Rehabil","first-page":"1469","article-title":"Moving bullet syndrome: a complication of penetrating head injury","volume":"79","author":"Zafonte","year":"1998","unstructured":"Zafonte RDWatanabe TMann NR.Moving bullet syndrome: a complication of penetrating head injury. Arch Phys Med Rehabil. 1998;79(11):1469-1472."},{"issue":"suppl 1","key":"bib30","series-title":"J Neurol Surg A","first-page":"e239","article-title":"Surgical management of basilar artery laceration caused by transorbital penetrating injury: case report","volume":"74","author":"Brenke","year":"2013","unstructured":"Brenke CFontana JSchmieder KBarth M.Surgical management of basilar artery laceration caused by transorbital penetrating injury: case report. J Neurol Surg A. 2013;74(suppl 1):e239-e241."},{"issue":"4","key":"bib31","series-title":"Can J Neurol Sci","first-page":"460","article-title":"Endovascular management of an embedded intracranial knife","volume":"34","author":"Darsaut","year":"2007","unstructured":"Darsaut TEAshforth RAChow MMFindlay JM.Endovascular management of an embedded intracranial knife. Can J Neurol Sci. 2007;34(4):460-463."},{"issue":"5","key":"bib32","series-title":"Surv Ophthalmol","first-page":"449","article-title":"Patterns of transorbital intracranial injury: a review and comparison of occult and non-occult cases","volume":"51","author":"Turbin","year":"2006","unstructured":"Turbin REMaxwell DNLanger PDPatterns of transorbital intracranial injury: a review and comparison of occult and non-occult cases. Surv Ophthalmol. 2006;51(5):449-460."},{"issue":"5","key":"bib33","series-title":"Neurosurgery","first-page":"1225","article-title":"Temporary balloon occlusion of the cavernous carotid artery for removal of an orbital and intracranial foreign body: case report","volume":"55","author":"Cunningham","year":"2004","unstructured":"Cunningham EJAlbani BMasaryk TJRasmussen PA.Temporary balloon occlusion of the cavernous carotid artery for removal of an orbital and intracranial foreign body: case report. 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J Am Coll Surg. 2014;218(1):58-65."},{"issue":"2","key":"bib3","series-title":"Neurol Med Chir (Tokyo)","first-page":"150","article-title":"Transorbital-transpetrosal penetrating cerebellar injury\u2014case report","volume":"39","author":"Kitakami","year":"1999","unstructured":"Kitakami AKirikae MKuroda KOgawa A.Transorbital-transpetrosal penetrating cerebellar injury\u2014case report. Neurol Med Chir (Tokyo). 1999;39(2):150-152."},{"key":"bib4","series-title":"Acute Care Neurosurgery by Case Management: Pearls and Pitfalls","author":"Raksin","year":"2022","unstructured":"Raksin PBAcute Care Neurosurgery by Case Management: Pearls and Pitfalls. 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J Emerg Crit Care Med. 2017;1(10):28-28."},{"issue":"3","key":"bib7","series-title":"Emerg Radiol","first-page":"301","article-title":"A review of penetrating brain trauma: epidemiology, pathophysiology, imaging assessment, complications, and treatment","volume":"24","author":"Vakil","year":"2017","unstructured":"Vakil MTSingh AK.A review of penetrating brain trauma: epidemiology, pathophysiology, imaging assessment, complications, and treatment. Emerg Radiol. 2017;24(3):301-309."},{"issue":"1","key":"bib8","series-title":"Scand J Trauma Resusc Emerg Med","first-page":"71","article-title":"The definition of major trauma using different revisions of the abbreviated injury scale","volume":"29","author":"Van Ditshuizen","year":"2021","unstructured":"Van Ditshuizen JCSewalt CAPalmer CS. The definition of major trauma using different revisions of the abbreviated injury scale. Scand J Trauma Resusc Emerg Med. 2021;29(1):71."},{"issue":"3","key":"bib9","series-title":"J Emerg Trauma Shock","first-page":"395","article-title":"Management of penetrating brain injury","volume":"4","author":"Kazim","year":"2011","unstructured":"Kazim SFShamim MSTahir MZEnam SAWaheed S.Management of penetrating brain injury. J Emerg Trauma Shock. 2011;4(3):395-402."},{"issue":"2","key":"bib10","series-title":"J Med Radiat Sci","first-page":"122","article-title":"Neuroimaging in adult penetrating brain injury: a guide for radiographers","volume":"62","author":"Temple","year":"2015","unstructured":"Temple NDonald CSkora AReed W.Neuroimaging in adult penetrating brain injury: a guide for radiographers. J Med Radiat Sci. 2015;62(2):122-131."},{"issue":"2","key":"bib11","series-title":"J Am Coll Radiol","first-page":"e1","article-title":"Imaging evidence and recommendations for traumatic brain injury: conventional neuroimaging techniques","volume":"12","author":"Wintermark","year":"2015","unstructured":"Wintermark MSanelli PCAnzai YImaging evidence and recommendations for traumatic brain injury: conventional neuroimaging techniques. J Am Coll Radiol. 2015;12(2):e1-e14."},{"issue":"1","key":"bib12","series-title":"Skull Base Rep","first-page":"39","article-title":"Management of nonmissile penetrating brain injuries: a description of three cases and review of the literature","volume":"1","author":"Sweeney","year":"2011","unstructured":"Sweeney JMLebovitz JJEller JLCoppens JRBucholz RDAbdulrauf SI.Management of nonmissile penetrating brain injuries: a description of three cases and review of the literature. 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World Neurosurg. 2016;91:297-307."},{"issue":"5","key":"bib17","series-title":"J Neurosurg","first-page":"1275","article-title":"Vascular complications of penetrating brain injury: comparison of helical CT angiography and conventional angiography","volume":"121","author":"Bodanapally","year":"2014","unstructured":"Bodanapally UKShanmuganathan KBoscak ARVascular complications of penetrating brain injury: comparison of helical CT angiography and conventional angiography. J Neurosurg. 2014;121(5):1275-1283."},{"issue":"6","key":"bib18","series-title":"World J Surg","first-page":"1352","article-title":"Current concepts in penetrating and blast injury to the central nervous system","volume":"39","author":"Rosenfeld","year":"2015","unstructured":"Rosenfeld JVBell RSArmonda R.Current concepts in penetrating and blast injury to the central nervous system. World J Surg. 2015;39(6):1352-1362."},{"issue":"2","key":"bib19","series-title":"Clin Neurol Neurosurg","first-page":"207","article-title":"Penetrating brain injury by drill bit","volume":"110","author":"Guti\u00e9rrez-Gonz\u00e1lez","year":"2008","unstructured":"Guti\u00e9rrez-Gonz\u00e1lez RBoto GRRivero-Garv\u00eda MP\u00e9rez-Zamarr\u00f3n AG\u00f3mez G.Penetrating brain injury by drill bit. Clin Neurol Neurosurg. 2008;110(2):207-210."},{"issue":"5","key":"bib20","series-title":"Neurosurgery","first-page":"1117","article-title":"Transcranial brainstem stab injuries: a retrospective analysis of 17 patients","volume":"47","author":"Nathoo","year":"2000","unstructured":"Nathoo NBoodhoo HNadvi SSNaidoo SRGouws E.Transcranial brainstem stab injuries: a retrospective analysis of 17 patients. 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