Transorbital-penetrating intracranial injury due to a homemade metal arrow: A case report

Abstract

A transorbital-penetrating intracranial injury (TOPI) is an unusual traumatic brain injury. This rare injury has the potential to result in serious and fatal brain damage with a high mortality rate and requires prompt multidisciplinary surgical intervention. Here, we describe an interesting case in which a patient who presented with accidental penetrating injuries of the brain was found to have a transorbital-penetrating intracranial injury (TOPI). We chose an anterior approach to the foreign body above the entrance wound for removal in a retrograde manner with fluoroscopic guidance. The patient remained well with no complications and was discharged on postoperative day 10. Reasonable diagnostic imaging, surgical planning, and careful post-surgery management can increase patients successful outcomes.

Brain Abscess Secondary to an Apparently Benign Transorbital Injury: An Infrequent Case Report with Literature Review

“…A brain abscess is a localized inflammatory response within the brain parenchyma characterized by the formation of a purulent collection [11]. Although relatively uncommon, it represents a significant and potentially severe complication that can arise following a transorbital-penetrating intracranial injury (TOPI) [12]. It should be noted that brain abscesses can develop even several decades after the initial head injury, as evidenced by a case study conducted by Kuromi et al [13].…”

Unusual transorbital-penetrating intracranial injury by a metal bar: A case report

“…Although TOPIs are not common, they can cause severe brain damage and significant ophthalmic and neurological disabilities. Therefore, the management of such cases needs a multidisciplinary approach involving both neurosurgeries as well as ophthalmology departments 5 . Previous reports have been published describing intracranial penetration via the orbit with various types of foreign bodies.…”

“…Surgical treatment is the primary strategy for this type of injury. The mortality rate for TOPI is 33% when timely surgical treatments are applied but increases to 53% in cases where surgery is delayed 5 .…”

Combined transcranial and transnasal endoscopic approach in transnasal-penetrating intracranial injury: A rare case report

“…Penetrating intracranial injuries include any damage to the head due to penetration by an object [1] . They can be divided into two groups based on the speed of penetration: high-velocity penetration (including gunshot injuries) [2] and low-velocity penetration (including injuries produced by a knife or other sharp items) [3] .…”

“…The processes of neuronal and vascular impairment resulting from non-missile injuries such as cranial stab wounds may differ from those resulting from other types of head trauma [6] , [7] . Even though the mortality rate of low-velocity penetration is not high, post-trauma complications such as cerebrospinal fluid (CSF) leakage, infection (abscess, empyema, meningitis, and ventriculitis), intra-ventricular bleeding, sinus thrombosis, and traumatic aneurysm are serious problems [1] , [3] , [7] .…”