{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T04:50:59Z","timestamp":1787028659338,"version":"build-2736575974"},"reference-count":45,"publisher":"MDPI AG","issue":"16","license":[{"start":{"date-parts":[[2025,8,13]],"date-time":"2025-08-13T00:00:00Z","timestamp":1755043200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Introduction: Non-missile penetrating brain injury (PBI) involving the anterior skull base constitutes a rare subclass of traumatic brain injury in civilians. Management of this type of trauma is poorly described in the literature, with only case series and reports available. Materials and Methods: A systematic search was conducted across PubMed, Scopus, and Web of Science databases. The study included reports of adult patients with non-missile PBI with foreign bodies crossing the anterior skull base, published between the years 2000 and 2024. The patients were divided into three groups based on the entry point of foreign bodies: transorbital, transmental, and transnasal injuries. The obtained data were analyzed through descriptive statistics. A case report of a 20-year-old male following PBI involving the anterior skull base caused by suicidal self-shooting with a crossbow is presented. Results: A total of 17 articles reporting 40 patients and the current case were included. The mean age of the patients was 37.4 \u00b1 13.1 years, and 92.7% of them were male. Transorbital injury was the dominant type of PBI (29 cases), followed by transmental injury (7 cases) and transnasal injury (5 cases). A total of 37 patients (90.2%) were managed operatively due to retained foreign bodies after PBI. Antibiotic prophylaxis was implemented in 33 cases (80.5%), mostly in transorbital (93.1%) and transnasal (100%) PBI. In seven reported cases, antiepileptic drugs were preventively administered. At the last follow-up, 18 patients (47.4%) did not fully recover neurological functions, with vision loss as the most common deficit. Conclusions: Management of non-missile PBIs involving the anterior part of the skull base is complex, challenging, and often requires a multidisciplinary team including neurosurgeons, ENT surgeons, ophthalmologists, and maxillofacial surgeons. In this type of traumatic brain injury, following proper management may lead to favorable outcomes with minimal neurological deficits.<\/jats:p>","DOI":"10.3390\/jcm14165731","type":"journal-article","created":{"date-parts":[[2025,8,13]],"date-time":"2025-08-13T13:30:38Z","timestamp":1755091838000},"page":"5731","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Management and Outcomes of Non-Missile Penetrating Brain Injury Involving the Anterior Skull Base: A Case Report and Systematic Review"],"prefix":"10.3390","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6949-2769","authenticated-orcid":false,"given":"Wojciech","family":"Czy\u017cewski","sequence":"first","affiliation":[{"name":"Department of Neurosurgery, Maria Sklodowska-Curie National Research Institute of Oncology, ul. W.K. Roentgena 5, 02-781 Warsaw, Poland"},{"name":"Department of Didactics and Medical Simulation, Medical University of Lublin, Chod\u017aki 4, 20-093 Lublin, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6061-8089","authenticated-orcid":false,"given":"Micha\u0142","family":"Szymoniuk","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Medical University of Lublin, Jaczewskiego 8, 20-090 Lublin, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7954-9263","authenticated-orcid":false,"given":"Jakub","family":"Litak","sequence":"additional","affiliation":[{"name":"Department of Clinical Immunology, Medical University of Lublin, Chod\u017aki 4a, 20-093 Lublin, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Krzysztof","family":"Kura","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Medical University of Lublin, Jaczewskiego 8, 20-090 Lublin, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0009-5467-9999","authenticated-orcid":false,"given":"Klaudia","family":"Ku\u015b-Budzy\u0144ska","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Medical University of Lublin, Jaczewskiego 8, 20-090 Lublin, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3603-4355","authenticated-orcid":false,"given":"Aleksandra","family":"Dryla","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Medical University of Lublin, Jaczewskiego 8, 20-090 Lublin, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1372-8987","authenticated-orcid":false,"given":"Jacek","family":"Baj","sequence":"additional","affiliation":[{"name":"Department of Correct, Clinical and Imaging Anatomy, Medical University of Lublin, Jaczewskiego 4, 20-090 Lublin, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kamil","family":"Torres","sequence":"additional","affiliation":[{"name":"Department of Didactics and Medical Simulation, Medical University of Lublin, Chod\u017aki 4, 20-093 Lublin, Poland"},{"name":"Department of Plastic, Reconstructive Surgery with Microsurgery, Medical University of Lublin, Jaczewskiego 8, 20-090 Lublin, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Grzegorz","family":"Sta\u015bkiewicz","sequence":"additional","affiliation":[{"name":"1st Department of Radiology, Medical University of Lublin, Jaczewskiego 8, 20-090 Lublin, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2025,8,13]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"255","DOI":"10.1016\/j.amjsurg.2018.11.034","article-title":"Trends in civilian penetrating brain injury: A review of 26,871 patients","volume":"218","author":"Skarupa","year":"2019","journal-title":"Am. 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