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CC BY 4.0 · Indian Journal of Neurotrauma
DOI: 10.1055/s-0044-1779287
Case Report

Craniofacial Injury in a Child by Agricultural Fan Blade: A Case Report

Abdul Vakil Khan
1   Department of Trauma and Emergency, All India Institute of Medical Sciences (AIIMS), Patna, Bihar, India
,
Majid Anwer
1   Department of Trauma and Emergency, All India Institute of Medical Sciences (AIIMS), Patna, Bihar, India
,
Anurag Kumar
1   Department of Trauma and Emergency, All India Institute of Medical Sciences (AIIMS), Patna, Bihar, India
,
Anil Kumar
1   Department of Trauma and Emergency, All India Institute of Medical Sciences (AIIMS), Patna, Bihar, India
,
Farheen Ahmed
2   Department of Anesthesiology and Critical Care, All India Institute of Medical Sciences (AIIMS), Patna, Bihar, India
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Abstract

Farm machine-related injuries in children are common modality of head injury. We describe here a case of threshing fan blade injury to head and its successful management. A 10-year-old male was brought to the emergency department of All India Institute of Medical Sciences (AIIMS) Patna with the complains of accidental fall on the fan blade of the thresher machine. On arrival he had a Glasgow Coma Scale of E1VTM5 status, bilateral pupil mid-dilated and sluggish reaction to light. On secondary survey, he had a lacerated wound of size 15 × 4 × 2 cm extending from left side forehead to right temporal region exposing bone and brain parenchyma herniation through the wound. A noncontrast computed tomography head showed B/L frontal contusion with gross edema, subarachnoid hemorrhage, and intraventricular hemorrhage. There was fracture of bilateral frontal bone extending to right parietotemporal bone. Patient was taken to operating room, where after painting and draping, the wound was irrigated with normal saline. The herniated brain was removed, securing hemostasis with surgical and Bovie cautery. He underwent a prolonged neurorehabilitation and made a complete recovery after 3 months of injury. Bihar is an eastern part of India where agriculture plays a major role in rural livelihood. Winnowing fan machines are used to separate the grain from the husk. Children have peculiar behavior to inspect things and this curious behavior leads to coming in contacts with the open blade. Falling on even a stationary blade can sometimes lead to head injury. Early surgery with meticulous wound debridement and closure of dura is required. Covering the fan blade as well as careful parenting of children will prevent further injuries.

Keywords

farm-related brain injury - fan blade injury - head injury - winnowing machine - tertiary center


Publication History

Article published online:
14 February 2024

© 2024. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution License, permitting unrestricted use, distribution, and reproduction so long as the original work is properly cited. (https://creativecommons.org/licenses/by/4.0/)

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