P.120 Traumatic penetrating head injury by crossbow projectiles: a case report and literature review

Background: Penetrating head injury secondary to crossbows is a rare encounter in neurosurgical practice with only few cases reported the literature. Methods: Chart review and literature review. Results: A 31-year-old man previous psychiatric history sustained self-inflicted using crossbow he bought from department store. The patient arrived neurologically intact. He was not able verbalize due jaw fixation arrow. trajectory of object showed an entry point at floor oral cavity exit through calvarium just off midline. nasal cavities, along palate skull base, left frontal lobe were all breached (figure). No vascular identified on imaging arrow surgically removed operating room after establishing elective surgical airway. planned delayed CSF leak repair performed. made substantial recovery discharged home good status. Conclusions: - Multidisciplinary team key. Vascular should be done pre post-intervention. Surgical approach determined by trajectory. Psychiatric illness access weapons are major risk factors. Elective airway might indicated.