Temporary Balloon Occlusion of the Cavernous Carotid Artery for Removal of an Orbital and Intracranial Foreign Body: Case Report

Abstract

Endovascular temporary balloon occlusion of the cavernous carotid artery provides immediate control of the vessel (with an option of permanent carotid sacrifice), allowing removal of a foreign body without craniotomy in appropriate cases.

Intracranial Self-Stabbing

“…64 Magnetic resonance imaging has the advantage of being able to detect nonmetallic foreign bodies, but is contradicted in the presence of metallic objects, when computerized tomography should be used. 19,26 CONCLUSION Despite the bizarre nature of the injuries and the presence of mental illness in many of the survivors, psychiatric aspects of the phenomenon of intracranial self-stabbing has received little attention in psychiatric journals. Direct extraction in association with angiography and intravascular methods to control intracerebral bleeding has been reported as an alternative to craniotomy.…”

Combined External-Endoscopic Endonasal Assisted Removal of a Nail Gun

“…3,4 Preoperative CT scan is the preferred modality to show bony landmarks and vascular structures; however, although both CT scan and magnetic resonance imaging are increasingly being used, in the case of nail gun injuries significant artefacts secondary to the nail probably preclude these studies. 5 Blind removal of foreign bodies has been reported, 6 however the development of combined-multiportal endoscopic approaches enabled surgeons to reach different regions through minimally invasive routes with lower incidence of complications, lower morbidity, and mortality rates compared with traditional external approaches. 4,[7][8][9] Reconstruction of anterior skull base defects remains the most challenging issue in this field with postoperative cerebrospinal fluid leak, 9 however, the introduction of different vascularized nasoseptal flaps dramatically decreased the rates of postoperative cerebrospinal fluid leak and improved the quality of life of patients, reducing postoperative nasal crusting and hospitalization time rates ranging from 3.3% to 4.3%.…”

Self-inflicted Orbital and Intracranial Pencil

“…A more invasive approach, such as inferior orbitotomy, may be required to gain enhanced orbital access for penetrating foreign body removal (5). Orbital and intracranial foreign bodies with minimal associated intracranial vascular injury may be removed without craniotomy in select cases via endovascular balloon occlusion of the involved intracranial vessels; however, angiographic evidence of vascular disruption is typically an indication for craniotomy to control potentially catastrophic hemorrhage during foreign body removal (6). Regardless of the method of removal, suspected intracranial foreign body penetration requires repeat angiography in 2-4 weeks after removal to detect interval hemorrhage or intracranial pseudoaneurysm formation, a potentially fatal delayed complication of orbital and intracranial foreign body removal (7).…”