Transorbital Intracranial Penetrating Injury From Impaling on an Earpick

Abstract

An inebriated 86-year-old man impaled himself on a wooden earpick that penetrated through the superior orbital fissure into the prepontine cistern. The patient underwent surgery immediately by a lateral suboccipital approach, and the earpick was pulled out through the wound with control of hemorrhage from the cavernous sinus. He survived this event with no neurologic deficits apart from complete ipsilateral ophthalmoplegia and ptosis. Prompt imaging and surgical intervention allowing direct visualization of the foreign body and prevention of intracranial complications are part of proper management of this problem.

Transorbital Penetrating Head Injury

“…As authors stated that these injuries-transorbital penetrating head injury or better known as transorbital orbitocranial penetrating injury (TOPI)-are uncommon, although they have been discussed in the literature with many case reports. [2][3][4][5][6][7][8][9] Even a case similar to the first case report (with almost similar findings) had been previously described in the literature by the same authors. 10 Before we label it as a case of TOPI, we need to clarify and understand the mechanism of these injuries and imaging findings.…”

Penetrating injury of orbit and skull with wooden stick from a tree: A rare case report

“…Orbital radiographs may be negative and are therefore unreliable in ruling out intracranial involvement, and therefore we would recommend that computed tomography should be performed when there is suspicion of secondary transorbital brain injury. Various cases of transorbital craniocerebral injury have been reported in the literature 3 involving door key, 4 nail, pencil, spectacle arm, 2 metal bar, ear pick, 5 bicycle brake handle, 6 plastic chop stick, wooden foreign body, ceramic stone and toilet brush handle. 7 These injuries are usually of a low velocity, localized, traverse a straight course and usually associated with a good clinical outcome.…”

Transorbital craniocerebral penetrating injury with iron cutting metal blade

“…Various cases of transorbital craniocerebral injury have been reported in the literature involving door key, nail, pencil, spectacle arm, metal bar, ear pick, bicycle brake handle, plastic chop stick, wooden foreign body, ceramic stone and toilet brush handle [4][5][6][7][8][9][10][11][12][13] . These injuries are usually of a low velocity, localized, traverse a straight course and usually associated with a good clinical outcome.…”