{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,3]],"date-time":"2026-02-03T10:53:54Z","timestamp":1770116034542,"version":"3.49.0"},"reference-count":42,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","issue":"17","license":[{"start":{"date-parts":[[2025,4,28]],"date-time":"2025-04-28T00:00:00Z","timestamp":1745798400000},"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":[[2025,4,28]]},"abstract":"\n BACKGROUND<\/jats:title>\n Although penetrating, nonmissile, traumatic cranial injuries with associated vascular injuries make up a small portion of all traumatic brain injuries, they can pose a unique challenge to the neurosurgeon. Recently, less invasive, endovascular treatment options have shown promise, but there remains a need for experience with open vascular treatment in certain circumstances. The authors describe the importance of careful surgical planning for open vascular repair of an internal carotid artery (ICA) transection injury after traumatic knife cranial penetration.<\/jats:p>\n <\/jats:sec>\n \n OBSERVATIONS<\/jats:title>\n The authors present the case of a 21-year-old Brazilian male, victim of domestic assault by knife, which penetrated the temporal bone, anterior temporal lobe, cranial nerves, cavernous sinus, and right ICA. Digital subtraction angiography showed right ICA occlusion with associated thrombosis of cervical through clinoidal segments, with adequate collateral perfusion. The authors performed a pterional craniotomy for clip ligation of the clinoidal segment of the ICA, with safe removal of the knife and a favorable patient outcome. The authors describe a technical case illustration, accompanied by a surgical video and cadaver and anatomical illustration.<\/jats:p>\n <\/jats:sec>\n \n LESSONS<\/jats:title>\n This case highlights the importance of detailed knowledge of cerebrovascular and skull base anatomy and preservation of complex open vascular neurosurgical techniques, especially in settings where endovascular treatment is not a feasible option.<\/jats:p>\n \n https:\/\/thejns.org\/doi\/10.3171\/CASE2532<\/jats:ext-link>\n <\/jats:p>\n <\/jats:sec>","DOI":"10.3171\/case2532","type":"journal-article","created":{"date-parts":[[2025,4,28]],"date-time":"2025-04-28T20:14:38Z","timestamp":1745871278000},"source":"Crossref","is-referenced-by-count":0,"title":["Open vascular treatment after internal carotid artery knife transection: illustrative case"],"prefix":"10.3171","volume":"9","author":[{"given":"Nicole A.","family":"Silva","sequence":"first","affiliation":[{"name":"Department of Neurosurgery, University of North Carolina, Chapel Hill, North Carolina"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Marco Antonio","family":"Leal Santos","sequence":"additional","affiliation":[{"name":"Department of Neurological Surgery, State University of Para, Santar\u00e9m, Par\u00e1, Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Herison H.","family":"Silva Vaz","sequence":"additional","affiliation":[{"name":"Department of Neurological Surgery, General Hospital of Roraima, Boa Vista, Roraima, Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Carlos A.","family":"David","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, University of North Carolina, Chapel Hill, North Carolina"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Erik Leonardo","family":"Jennings Sim\u00f5es","sequence":"additional","affiliation":[{"name":"Department of Neurological Surgery, State University of Para, Santar\u00e9m, Par\u00e1, Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1754","reference":[{"key":"bib1","series-title":"Clin Ophthalmol","first-page":"1103","article-title":"Surgical treatment of a transorbital penetrating brain injury","volume":"4","author":"Paiva","year":"2010","unstructured":"Paiva WSMonaco BPrudente MSurgical treatment of a transorbital penetrating brain injury. Clin Ophthalmol. 2010;4:1103-1105."},{"key":"bib2","series-title":"Surg Neurol Int","first-page":"152","article-title":"Penetrating intracranial nail-gun injury to the middle cerebral artery: a successful primary repair","volume":"6","author":"Isaacs","year":"2015","unstructured":"Isaacs AMYuh SJHurlbert RJMitha AP.Penetrating intracranial nail-gun injury to the middle cerebral artery: a successful primary repair. Surg Neurol Int. 2015;6:152."},{"issue":"2","key":"bib3","series-title":"Turk Neurosurg","first-page":"121","article-title":"Intracranial foreign body","volume":"17","author":"G\u00f6k\u00e7ek","year":"2007","unstructured":"G\u00f6k\u00e7ek CErdem YK\u00f6ktekir EIntracranial foreign body. Turk Neurosurg. 2007;17(2):121-124."},{"issue":"9","key":"bib4","series-title":"J Trauma","first-page":"1193","article-title":"Mortality of patients with head injury and extracranial injury treated in trauma centers","volume":"29","author":"Gennarelli","year":"1989","unstructured":"Gennarelli TAChampion HRSacco WJCopes WSAlves WM.Mortality of patients with head injury and extracranial injury treated in trauma centers. J Trauma. 1989;29(9):1193-1202."},{"key":"bib5","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":"4","key":"bib6","series-title":"Asian J Neurosurg","first-page":"1034","article-title":"Transcranial stab injury with knife: a rare case with excellent outcome","volume":"15","author":"Garg","year":"2020","unstructured":"Garg RWadhwa CKaushal RSingh J.Transcranial stab injury with knife: a rare case with excellent outcome. Asian J Neurosurg. 2020;15(4):1034-1036."},{"issue":"5","key":"bib7","series-title":"Neurosurgery","first-page":"905","article-title":"Penetrating stab wounds to the brain: the timing of angiography in patients presenting with the weapon already removed","volume":"31","author":"du Trevou","year":"1992","unstructured":"du Trevou MDvan Dellen JR.Penetrating stab wounds to the brain: the timing of angiography in patients presenting with the weapon already removed. 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Clin Neurol Neurosurg. 2008;110(2):207-210."},{"issue":"3","key":"bib14","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":"6","key":"bib15","series-title":"South Med J","first-page":"608","article-title":"Multiple self-inflicted nail gun head injury","volume":"100","author":"Testerman","year":"2007","unstructured":"Testerman GMDacks LM.Multiple self-inflicted nail gun head injury. 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BMJ Case Rep. 2019;12(4):e227915."},{"key":"bib20","series-title":"World Neurosurg","first-page":"21","article-title":"Use of pterional craniotomy for removal of penetrating object: case report and surgical video","volume":"126","author":"O\u2019Connor","year":"2019","unstructured":"O\u2019Connor KPPalejwala AHBriggs RGMassoth LArgo JLGlenn CA.Use of pterional craniotomy for removal of penetrating object: case report and surgical video. World Neurosurg. 2019;126:21-23."},{"key":"bib21","series-title":"Temas Atuais em Neurocirurgia:","article-title":"Tratamento Cir\u00fargico Das Les\u00f5es na Regi\u00e3o do Seio Cavernoso","author":"Tedeschi","unstructured":"Tedeschi H, OliveraETzuWHRhotonAL Jr. Temas Atuais em Neurocirurgia: Tratamento Cir\u00fargico Das Les\u00f5es na Regi\u00e3o do Seio Cavernoso. Sociedade de Neurocirurgia do Estado de S\u00e3o Paulo; 2004. 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Surg Neurol Int. 2015;6:152."},{"issue":"2","key":"bib3","series-title":"Turk Neurosurg","first-page":"121","article-title":"Intracranial foreign body","volume":"17","author":"G\u00f6k\u00e7ek","year":"2007","unstructured":"G\u00f6k\u00e7ek CErdem YK\u00f6ktekir EIntracranial foreign body. Turk Neurosurg. 2007;17(2):121-124."},{"issue":"9","key":"bib4","series-title":"J Trauma","first-page":"1193","article-title":"Mortality of patients with head injury and extracranial injury treated in trauma centers","volume":"29","author":"Gennarelli","year":"1989","unstructured":"Gennarelli TAChampion HRSacco WJCopes WSAlves WM.Mortality of patients with head injury and extracranial injury treated in trauma centers. J Trauma. 1989;29(9):1193-1202."},{"key":"bib5","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":"4","key":"bib6","series-title":"Asian J Neurosurg","first-page":"1034","article-title":"Transcranial stab injury with knife: a rare case with excellent outcome","volume":"15","author":"Garg","year":"2020","unstructured":"Garg RWadhwa CKaushal RSingh J.Transcranial stab injury with knife: a rare case with excellent outcome. Asian J Neurosurg. 2020;15(4):1034-1036."},{"issue":"5","key":"bib7","series-title":"Neurosurgery","first-page":"905","article-title":"Penetrating stab wounds to the brain: the timing of angiography in patients presenting with the weapon already removed","volume":"31","author":"du Trevou","year":"1992","unstructured":"du Trevou MDvan Dellen JR.Penetrating stab wounds to the brain: the timing of angiography in patients presenting with the weapon already removed. Neurosurgery. 1992;31(5):905-912."},{"issue":"1","key":"bib8","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."},{"issue":"12","key":"bib9","series-title":"Neurol Med Chir (Tokyo)","first-page":"590","article-title":"Unstable stenosis of the internal carotid artery caused by a craniofacial nail-gun injury-case report","volume":"49","author":"Hiraishi","year":"2009","unstructured":"Hiraishi TKawaguchi TKobayashi TTomikawa MIto YFujii Y.Unstable stenosis of the internal carotid artery caused by a craniofacial nail-gun injury-case report. Neurol Med Chir (Tokyo). 2009;49(12):590-593."},{"issue":"suppl 2","key":"bib10","series-title":"Neurosurgery","first-page":"E372","article-title":"Retained transcranial knife blade with transection of the internal carotid artery treated by staged endovascular and surgical therapy: technical case report","volume":"11","author":"Kodadek","year":"2015","unstructured":"Kodadek LMLeeper WRCaplan JMMolina CStevens KAColby GP.Retained transcranial knife blade with transection of the internal carotid artery treated by staged endovascular and surgical therapy: technical case report. Neurosurgery. 2015;11(suppl 2):E372-E375."},{"key":"bib11","series-title":"World Neurosurg","first-page":"237","article-title":"Coil embolization of the internal carotid artery in patient with retained transcranial knife","volume":"127","author":"George","year":"2019","unstructured":"George RAhmad SNgqandu MD.Coil embolization of the internal carotid artery in patient with retained transcranial knife. World Neurosurg. 2019;127:237-240."},{"issue":"4","key":"bib12","series-title":"J Neurosurg","first-page":"1080","article-title":"Estimating the global incidence of traumatic brain injury","volume":"130","author":"Dewan","year":"2018","unstructured":"Dewan MCRattani AGupta SEstimating the global incidence of traumatic brain injury. J Neurosurg. 2018;130(4):1080-1097."},{"issue":"2","key":"bib13","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":"3","key":"bib14","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":"6","key":"bib15","series-title":"South Med J","first-page":"608","article-title":"Multiple self-inflicted nail gun head injury","volume":"100","author":"Testerman","year":"2007","unstructured":"Testerman GMDacks LM.Multiple self-inflicted nail gun head injury. 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Neurol Med Chir (Tokyo). 2005;45(3):172-175."},{"issue":"4","key":"bib18","series-title":"J Neurosurg","first-page":"512","article-title":"Patients with retained transcranial knife blades: a high-risk group","volume":"87","author":"Taylor","year":"1997","unstructured":"Taylor AGPeter JC.Patients with retained transcranial knife blades: a high-risk group. J Neurosurg. 1997;87(4):512-515."},{"issue":"4","key":"bib19","series-title":"BMJ Case Rep","first-page":"e227915","article-title":"Penetrating intracranial trauma of two minors treated with endovascular technique with the use of temporary balloon occlusion for proximal arterial control","volume":"12","author":"Kacheris","year":"2019","unstructured":"Kacheris BNJallo GCrooms JWOliver TALawson MFBeaty N.Penetrating intracranial trauma of two minors treated with endovascular technique with the use of temporary balloon occlusion for proximal arterial control. BMJ Case Rep. 2019;12(4):e227915."},{"key":"bib20","series-title":"World Neurosurg","first-page":"21","article-title":"Use of pterional craniotomy for removal of penetrating object: case report and surgical video","volume":"126","author":"O\u2019Connor","year":"2019","unstructured":"O\u2019Connor KPPalejwala AHBriggs RGMassoth LArgo JLGlenn CA.Use of pterional craniotomy for removal of penetrating object: case report and surgical video. World Neurosurg. 2019;126:21-23."},{"key":"bib21","series-title":"Temas Atuais em Neurocirurgia:","article-title":"Tratamento Cir\u00fargico Das Les\u00f5es na Regi\u00e3o do Seio Cavernoso","author":"Tedeschi","unstructured":"Tedeschi H, OliveraETzuWHRhotonAL Jr. Temas Atuais em Neurocirurgia: Tratamento Cir\u00fargico Das Les\u00f5es na Regi\u00e3o do Seio Cavernoso. Sociedade de Neurocirurgia do Estado de S\u00e3o Paulo; 2004. 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