An unusual case of orbito-frontal rod fence stab injury with a good outcome

Abstract

BackgroundHigh-energy non-missile penetrating injuries (stab injuries) account for a small percentage of penetrating head injuries and they present a series of special features.Case presentationA 35-year-old man suffered orbito-frontal? and trans-cranial injuries after falling five meters from a terrace onto a rod iron fence. The removal of the metal rod was performed outside the operating room. The orbital roof was exposed and repaired through a bifrontal craniotomy and the frontal sinuses were cranialised. The orbital floor and zygoma were plated with micro-screws.ConclusionThe patient recovered without significant complications, apart from a slight paresis of the right superior rectus; the ocular globe remained intact.The positive outcome obtained in this very challenging case is attributable to the competency of the Neurotrauma Unit and to the use of a synergistic approach which involved the contribution of neurosurgeons, maxillo-facial surgeons, radiologists and anaesthesiologists.

Cranial Impalement of a Falling Fence Spike in a Child: A Case Report

“…Unlike in missile injuries, there is no concentric zone of coagulative necrosis caused by dissipated energy; and unlike in motor vehicle accidents, no diffuse shearing injury to the brain occurs. [12] However, more extensive cerebral and/or vascular damage is an ever present danger if the foreign object is mobilized or removed prematurely, and this is one of the key considerations in patient handling. [13] The management of impaled foreign objects usually presents a challenge.…”

“…[1] An extensive list of objects have been reported to cause impalement injuries in children including the rotor blade of a fan, electric plug, pencil, dart, wooden chopstick, curtain rail, defective badminton racquet, metallic cloth hanger, knife, nail, fork, scissors, and other assorted objects. [4][5][6][7][8][9][10][11][12] Cranial penetration is most commonly through thin bones of the skull, especially the orbital surfaces and the squamous portion of the temporal bone. [12] Unless an associated hematoma or infarct is present, cerebral damage caused by cranial impalement is largely restricted to the wound tract.…”

“…[4][5][6][7][8][9][10][11][12] Cranial penetration is most commonly through thin bones of the skull, especially the orbital surfaces and the squamous portion of the temporal bone. [12] Unless an associated hematoma or infarct is present, cerebral damage caused by cranial impalement is largely restricted to the wound tract. Unlike in missile injuries, there is no concentric zone of coagulative necrosis caused by dissipated energy; and unlike in motor vehicle accidents, no diffuse shearing injury to the brain occurs.…”

Penetrating Brain Injury with a bike key - a case report

“…The weapons range from knives and chopsticks to scissors and door keys. [1] To date, there have only been two case reports of PBI caused with a key. [2,3] Bike key used as a weapon is being reported for the first time in the literature.…”

A successfully-treated case of penetrating facial trauma

“…Immediate complications of transfacial penetrating trauma include cerebral contusion, intracerebral hematoma, pneumocephalus, intraventricular hemorrhage, cranial nerve damage, severe permanent neurological damage, and brain stem and cerebrovascular injury [2]. Delayed complications include cerebrospinal fluid fistula, pneumocephalus, orbital cellulitis, carotid-cavernous sinus fistula, central nervous system infections, traumatic aneurysm, and delayed intracranial hemorrhage [3].…”