Question 927
{"accessible":false,"alternatives":[{"id":4662,"text":"CT angiography should be performed in most penetrating injuries involving the base of skull"},{"id":4663,"text":"high velocity projectiles cause significant injury distal to their trajectory"},{"id":4664,"text":"not all bone fragments and foreign bodies fragments should be removed from the brain parenchyma"},{"id":4665,"text":"velocity of a projectile has more impact on kinetic energy than weight"},{"id":4666,"text":"wood is usually only slightly hyperattenuating to muscle and blood on CT "}],"archived":false,"correctAlternativeId":4666,"explanation":"\u003cp\u003eWood is usually lower than soft tissues due to water and air, resulting in hypoattenuation on brain window that can be mistaken for air.\u0026nbsp;\u003c/p\u003e\u003cp\u003eEnergy is equal to 1/2mv\u003csup\u003e2\u003c/sup\u003e, and thus the velocity of a projectile is more important than its mass.\u0026nbsp;\u003c/p\u003e\u003cp\u003eHigh-velocity projectiles result in a cavitary shockwave which damages tissues at significant distances from the injury trajectory.\u0026nbsp;\u003c/p\u003e\u003cp\u003eMany fragments of bullets may be distant to the main trajectory of injury and are not easily identified at surgery. Many of these should be left in situ although if located near eloquent cortex, leaving them in situ may increase post-traumatic epilepsy \u003csup\u003e1\u003c/sup\u003e.\u0026nbsp;\u003c/p\u003e\u003cp\u003e\u0026nbsp;\u003c/p\u003e\u003cp\u003e\u003cstrong\u003eReference\u003c/strong\u003e\u003c/p\u003e\u003col\u003e\u003cli\u003eKazim SF, Shamim MS, Tahir MZ, Enam SA, Waheed S. Management of penetrating brain injury. Journal of emergencies, trauma, and shock. 4 (3): 395-402.\u0026nbsp;\u003c/li\u003e\u003c/ol\u003e","id":927,"imageUrl":null,"imageAttribution":null,"imageAttributionCaseInfo":null,"firstQuestionPath":"/questions/927","nextQuestionPath":"/articles/high-velocity-penetrating-brain-injury/questions/924","relatedArticles":[{"id":56191,"title":"Low-velocity penetrating brain injury","link":"/articles/low-velocity-penetrating-brain-injury?lang=us"}],"alsoUsedIn":[{"id":119,"kind":"Course","title":"Emergency Radiology Course - Melbourne - page 119","link":"https://radiopaedia.org/courses/emergency-radiology-course-melbourne-2020/pages/119"},{"id":119,"kind":"Course","title":"Trauma Radiology Course - Sydney - page 119","link":"https://radiopaedia.org/courses/trauma-radiology-course-sydney-2020/pages/119"},{"id":119,"kind":"Course","title":"Trauma CT Brain Learning Pathway - page 119","link":"https://radiopaedia.org/courses/trauma-ct-brain-learning-pathway/pages/119"}],"stem":"\u003cp\u003eWhich of the following statements regarding penetrating brain injuries is \u003cstrong\u003eINCORRECT\u003c/strong\u003e?\u003c/p\u003e","menuLinks":[{"text":"Report problem with question","url":"https://docs.google.com/forms/d/e/1FAIpQLSfO3soWYhOjJ7yErSysyCe5V4A1CqW7WK3rDA7MtAkecMGqNw/viewform?entry.1624461248\u0026entry.553583435=https://radiopaedia.org/questions/927"}],"attemptsPercentages":[{"alternativeId":"4664","percentage":20},{"alternativeId":"4665","percentage":8},{"alternativeId":"4666","percentage":55},{"alternativeId":"4663","percentage":8},{"alternativeId":"4662","percentage":9}],"promptToLogin":false,"questionManager":false,"articleId":"high-velocity-penetrating-brain-injury"}