1110 - Pediatric Penetrating Brain Injury by Meat Thermometer: Case Report

Case Diagnosis: Non-missile penetrating brain injuries (PBIs) are an uncommon type of traumatic brain injury,

particularly in the pediatric population, accounting for 0.4% of all brain injuries. PBIs in pediatrics differ from adult care due to children’s softer squamous cranial bones. Clinical presentations of non-missile intracranial injuries are highly variable. There have been no previously reported cases of

a penetrating brain injury by meat thermometer, which we present here.

Case Description: A 23-month-old female with no previous developmental delays presented after falling onto a

meat thermometer. Initial Glasgow Coma Scale (GCS) was 5 (E1V1M3). Computerized tomography (CT) revealed a left squamous temporal bone fracture and injury extending obliquely through the cerebral parenchyma across the midline with the sharp tip ending at the right basal ganglia. A left temporal craniotomy was performed to remove the penetrating object.



Discussions:

The injury resulted in severe left hemiparesis, left-sided hemineglect, speech language deficits, and expressive aphasia. Inpatient Physical Medicine and Rehabilitation service began six days post-op. The patient was discharged home after 26 days total, including 3 weeks of intensive PT, OT, and SLP. At the time of discharge, the patient had mild deficits in auditory comprehension and moderate deficits in expressive communication with improving left hemiparesis.



Conclusions:

Pediatric penetrating brain injuries have various effects depending on the location of the injury and depth of penetration. In this case, the areas of the brain impacted were the temporal lobe and thalamus, resulting in impacts on neurological functioning such as hemineglect, hemiparesis, and moderate speech deficits.




With just over three weeks of intense therapy, she was able to significantly improve her left-sided hemineglect, hemianesthesia and hemiparesis. The patient in this case, at not yet two years old has a favorable prognosis of continued improvement with motor skills and attention.