Abstract
BackgroundHigh-energy non-missile penetrating injuries (stab injuries) account for a small percentage of penetrating head injuries and they present a series of special features.Case presentationA 35-year-old man suffered orbito-frontal? and trans-cranial injuries after falling five meters from a terrace onto a rod iron fence. The removal of the metal rod was performed outside the operating room. The orbital roof was exposed and repaired through a bifrontal craniotomy and the frontal sinuses were cranialised. The orbital floor and zygoma were plated with micro-screws.ConclusionThe patient recovered without significant complications, apart from a slight paresis of the right superior rectus; the ocular globe remained intact.The positive outcome obtained in this very challenging case is attributable to the competency of the Neurotrauma Unit and to the use of a synergistic approach which involved the contribution of neurosurgeons, maxillo-facial surgeons, radiologists and anaesthesiologists.
Highlights
High-energy non-missile penetrating injuries account for a small percentage of penetrating head injuries and they present a series of special features.Case presentation: A 35-year-old man suffered orbito-frontal? and trans-cranial injuries after falling five meters from a terrace onto a rod iron fence
Case presentation We present the case of a 35-year-old man who suffered a high-energy non-missile orbito-frontal? penetrating brain injury after falling five meters from a terrace onto a rod iron fence
The rod was removed in the Emergency Room without any radiological control; a consequent CT scan revealed that the injury involved the right orbit floor, roof and zygoma, both the frontal sinus and the frontal lobes and had caused a frontal post-traumatic acute subdural haemorrhage
Summary
The patient recovered without significant complications, apart from a slight paresis of the right superior rectus; the ocular globe remained intact. The positive outcome obtained in this very challenging case is attributable to the competency of the Neurotrauma Unit and to the use of a synergistic approach which involved the contribution of neurosurgeons, maxillo-facial surgeons, radiologists and anaesthesiologists
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