PMC:6720993 / 1883-3374 JSONTXT

{"target":"http://pubannotation.org/docs/sourcedb/PMC/sourceid/6720993","sourcedb":"PMC","sourceid":"6720993","source_url":"https://www.ncbi.nlm.nih.gov/pmc/6720993","text":"2. Case Presentation\nA 69-year-old Asian man noticed a titanium plate penetrating through his scalp in the right temporal region one week prior to visiting our clinic. The patient had a history of subarachnoid hemorrhage and had undergone clipping surgery of a ruptured middle cerebral artery aneurysm with pterional craniotomy 16 years previously. One month prior to visiting our clinic, he hit his right temporal region on a wall cabinet and noticed something hard bulging subcutaneously at the point of impact. Three weeks after the head trauma, he noticed the plate protruding through his scalp (Figure 1(a)). Three-dimensional computed tomography (3D-CT) scan revealed that part of the titanium plate had been bent and was penetrating the skin (Figure 1(b)). The plate was removed and the skin defect repaired. Figure 1(c) shows the removed plate and the bend in it.\nUnder general anesthesia, a skin incision was made along the plate to expose it (Figure 2(a)), and then the plate and screws were completely removed (Figure 2(b)). After debridement around the skin defect, a relief skin incision was made 6 cm posterior to it (Figure 2(c)) to enable suturing of the defect portion without causing tension (Figure 2(d), arrow). The relief skin incision portion was covered with a graft from the outer layer of the skin of the right thigh (Figure 2(e)). Two months later, the skin incision had healed without infection and the skin graft had been successfully incorporated (Figure 2(f)).","divisions":[{"label":"title","span":{"begin":0,"end":20}},{"label":"p","span":{"begin":21,"end":872}}],"tracks":[]}