Citation

Mzimbiri JM, Li J, Bajawi MA, Song L, Fenghua C, Liu J. World Neurosurg. 2015; 87: 26-34.

Affiliation

Department of Neurosurgery, Xiangya Hospital of Central South University,Changsha,Hunan410008,China. Electronic address: 1427822007@qq.com.

Copyright

(Copyright © 2015, Elsevier Publishing)

DOI

10.1016/j.wneu.2015.12.063

PMID

26724632

Abstract

BACKGROUND: Orbitocranial penetrating injuries (OPI) are an unfamiliar subset of head injury and are particularly rare in clinical practice. They are usually the result of falls or motor vehicle collisions and occur more commonly in children because they are prone to trauma while playing games improperly. CASE DESCRIPTION: The authors present a retrospective review of five cases of OPI treated in the Neurotrauma Department at Xiangya Hospital of Central South University in the last five years. Two patients experienced right internal carotid artery (ICA) occlusion as well as a congenital absence of the right posterior communicating artery (Pcomm). In two patients, the penetrating objects reached the brainstem through the cavernous sinus, resulting in orbital apex syndrome. Comprehensive literature searches using Web of Science were performed using the terms "orbitocranial injury", "penetrating ocular trauma,"; "penetrating orbital trauma,"; and "transorbital chopstick penetrating injury,"; to search for presentation, mechanism of injury and management of transorbital penetrating injury. All of the cases underwent thorough physical examination followed by diagnostic imaging.

CONCLUSIONS: Computed tomography (CT), magnetic resonance imaging (MRI) and CT angiography are the key imaging modalities that are frequently used to determine the course of the object and; the extent of brain tissue injury as well as to rule out vascular injury in these type of cases. The cases demonstrated good evolution in the surgical context and were successfully managed surgically by removing the foreign body through their trajectories. Early surgical exploration by a multidisciplinary team approach is essential for attaining good recovery and favorable outcome.

Language: en