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

Abstract

The orbit has a fine bony structure and represents the most vulnerable structure in the cranium. Therefore, penetrating orbital injuries are often associated with traumatic brain injury. Although transorbital-penetrating intracranial injury is not commonly encountered in emergency medicine practice, this occurrence has the potential to cause severe and fatal brain injury. In this study, we report the case of a 21-year-old male patient presented with an injury to his left orbit, caused by falling while holding a metal bar. A local examination revealed a perforating injury at the entry location of a metallic bar (S-shaped) that penetrated his left orbit. CT imaging showed the appearance of a metallic foreign body that entered anterior superior to the left orbit, passed into the left half of the frontal sinus, and extended into the intracranial area. The metallic bar was removed by craniotomy. The patient fully recovered and was discharged on postoperative 9th day. The penetration of foreign bodies through the orbitofrontal region is rare but potentially life-threatening. An emergent surgical initiative is necessary to save the life of the patient. When managed in a timely and efficient manner, the associated mortality and morbidity can be reduced.