Patterns of Transorbital Intracranial Injury: A Review and Comparison of Occult and Non-Occult Cases

Turbin, Roger E.; Maxwell, Dawn N.; Langer, Paul D.; Frohman, Larry; Hubbi, Basil; Wolansky, Leo; Mori, Mayumi

doi:10.1016/j.survophthal.2006.06.008

Cited by 121 publications

(203 citation statements)

References 44 publications

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“…The orbit is a osseous structure shaped as a horizontal pyramid, with a quadrangular base formed by the orbital rim, and with triangular orbital walls that converge to the apex, where the superior orbital fissure (SOF), inferior orbital fissure (IOF) and optic canal (OC) are found (12,36) (Figure 4. B).…”

Section: Discussionmentioning

confidence: 99%

“…For OPI with low-velocity, the most frequent injury pattern encountered in 68% of cases is represented by the damage of temporal lobe, brainstem and cavernous sinus (36).…”

Section: Discussionmentioning

confidence: 99%

“…So that in case of OPI with low-velocity, intracranial brain injury may occur in presence of minimal periorbital trauma, without bone fractures. The explanation would be represented by toughness of the sclera coat and the motility of the eyeball within the surrounding bed of intraorbital fat (11,26) that protects eyeball from penetration during OPI with lowvelocity (36).…”

Section: Discussionmentioning

confidence: 99%

“…If in OPI with low-velocity the ocular complications are minimal or even absent, this is not the case for OPI with high-velocity, such as pellet and nail gun injuries or work accidents, in which despite the small diameter of penetrating foreign body, there is important damage done to the eye globe (2,32,36). The most frequent ocular complications encountered are: ocular laceration, retrobulbar hematoma, proptosis and optic nerve damage with severe loss of vision (19,31), and in our patient's case, despite the minor damage done to the eyelid (Figure 1), the damage done to the globe was severe: eyelid ptosis, vitreous hemorrhage, retinal detachment (Figure 1, Figure 3.…”

Section: Discussionmentioning

confidence: 99%

“…Orbitocranial penetrating injuries (OPI) represent about 24% of penetrating head injuries in adults and 45% in children (36), and they represent a significant threat for the intracranial and ocular structures. OPI occur relatively rare among adults and more frequent in children and teenagers, because they are prone to injuries while they play games in inappropriate ways (29,37).…”

Section: Introductionmentioning

confidence: 99%

See 4 more Smart Citations

Orbitocranial penetrating injury by a metallic foreign body. Case report and anatomical considerations

Turliuc¹,

Cucu²,

Dumitrescu³

et al. 2017

Romanian Neurosurgery

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Abstract:Orbitocranial penetrating injuries (OPI) represent a rare type of head injuries encountered in clinical practice. These appear after falls or motor vehicle accidents and are more frequent among children. We present the case of a male patient with OPI, associated with large frontal hemorrhagic contusion, with minimal periorbital trauma findings related to brain injury. Knowing and understanding the clinical anatomy of the orbit and the patterns of injuries in OPI are mandatory, since failure in detecting intracranial complications may lead to the increase of the neurological morbidity, visual loss and death.

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Section: Discussionmentioning

confidence: 99%

“…For OPI with low-velocity, the most frequent injury pattern encountered in 68% of cases is represented by the damage of temporal lobe, brainstem and cavernous sinus (36).…”

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

Orbitocranial penetrating injury by a metallic foreign body. Case report and anatomical considerations

Turliuc¹,

Cucu²,

Dumitrescu³

et al. 2017

Romanian Neurosurgery

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Day 14 intervention for penetrating brain injury with a good Glasgow Coma Scale score: A case report

Matsubara

Sakamoto

Takahashi

et al. 2022

Clinical Case Reports

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Transorbital penetrating intracranial injury involving bilateral frontal lobes with evisceration of right eye: A case report

Siddiqui,

Kariem,

Fayaz

et al. 2024

Clinical Case Reports

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Key Clinical MessageTimely diagnosis, multidisciplinary surgical intervention, and appropriate imaging are crucial in managing transorbital‐penetrating intracranial injuries (TOPIs), minimizing morbidity, and optimizing patient outcomes.AbstractTransorbital‐penetrating intracranial injuries (TOPIs) are rare occurrences with potential for severe neurological complications and high mortality rates. Prompt diagnosis and management are essential to mitigate adverse outcomes. Understanding injury patterns and employing appropriate imaging modalities are crucial for effective surgical planning and patient care. We present a case of a 22‐year‐old male mechanic who sustained a TOPI involving bilateral frontal lobes with evisceration of the right eye following a workplace accident with a metal cutter. Upon arrival at the emergency department, the patient exhibited vision loss in the right eye, proptosis, and a dilated pupil. Imaging studies revealed the trajectory of a metal arrow through the right orbital roof, necessitating surgical intervention. A multidisciplinary team performed bifrontal craniectomy with duroplasty to remove the foreign body and address associated injuries. Postoperatively, the patient received broad‐spectrum antibiotics and anticonvulsants, leading to full recovery and discharge on postoperative day 10. TOPIs present unique challenges due to their rarity and potential for devastating consequences. Our case highlights the importance of timely diagnosis, meticulous surgical planning, and multidisciplinary collaboration in achieving favorable outcomes. Radiological imaging plays a crucial role in guiding treatment decisions and optimizing patient care. This report underscores the significance of early surgical intervention, antimicrobial therapy, and prophylactic measures in reducing morbidity and mortality associated with TOPIs.

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Patterns of Transorbital Intracranial Injury: A Review and Comparison of Occult and Non-Occult Cases

Cited by 121 publications

References 44 publications

Orbitocranial penetrating injury by a metallic foreign body. Case report and anatomical considerations

Orbitocranial penetrating injury by a metallic foreign body. Case report and anatomical considerations

Day 14 intervention for penetrating brain injury with a good Glasgow Coma Scale score: A case report

Transorbital penetrating intracranial injury involving bilateral frontal lobes with evisceration of right eye: A case report

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