Publication Type Case Report
Authors Mkony D, Magogo Mzimbiri J, Leidinger A, Bonfield C, Zuckerman S, Härtl R
Journal J Neurosurg Pediatr
Volume 25
Issue 6
Pagination 659-662
Date Published 02/28/2020
ISSN 1933-0715
Abstract A 3-year-old boy presented after a hyena bite to the skull in Tanzania. A large degloving wound with herniating cerebrum was seen in the right parietotemporal region. A CT scan confirmed a large 8-cm skull defect. The patient was taken for irrigation and debridement, but due to significant tissue loss, the skin could not be closed. CSF leaked from the wound, and two additional operations for attempted closure were undertaken but failed. The plastic surgery team was consulted, but no closure was done because of the procedure's complexity, lack of resources, and cost. CSF diversion could not be performed due to no available lumbar catheter or external ventricular drain. Meningitis developed, leading to severe hyponatremia and death. The current case highlights both the unique mechanism of a hyena bite requiring neurosurgical intervention and the realities of practicing neurosurgery in a low-resource setting.
DOI 10.3171/2019.12.PEDS19495
PubMed ID 32109867
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