A case report of a transorbital penetrating intracranial injury from a motorcycle side mirror metal bar
- Author:
Kia Charisse D. de Asis
1
;
Mark Anthony T. Imperial
1
,
2
Author Information
- Publication Type:Journal Article
- Keywords: Metal bar; Intraorbital foreign body; Transorbital injury; Orbitocranial injury; Penetrating trauma
- From: Philippine Journal of Ophthalmology 2023;48(2):82-86
- CountryPhilippines
- Language:English
-
Abstract:
Objective:To present a case of transorbital penetrating intracranial injury successfully managed using a
stepwise multispecialty approach.
Methods:This is a case report.
Results:A 26-year-old male presented with a motorcycle side-mirror metal bar impaled into his right orbit. He had a Glasgow Coma Scale (GCS) score of 12. Computed tomography (CT) imaging revealed the metal bar’s trajectory from the right lateral canthus, traversing the superior orbital wall and frontal lobe, resulting in contusion, intracranial hemorrhages and multiple orbital and facial fractures. Despite the severity of the injury, the right globe was found to be intact during intraoperative exploration. The transorbital approach was employed for safe removal of the penetrating object, followed by repair of full-thickness eyelid laceration and transections of the lateral and medial canthi. Subsequently, the Neurosurgery service conducted a right pterional craniotomy, debridement, and duraplasty. Upon discharge, the visual acuity on the right eye was 20/50.
Conclusion:Transorbital penetrating intracranial injuries are rare and result in vision loss and life-threatening complications. A transorbital approach in removing a penetrating foreign body can be adopted when injury to cerebral tissues is imminent. Individualizing the management and employing a multispecialty approach can lead to favorable outcomes. - Full text:8 pjo.pdf
