Penetrating orbito-cranial injury in a child

Abstract

Introduction: Penetrating brain injury is a very common form of head injury all over the world. It commonly follows missile injury and impalement from assaults and fall on a sharp object. Rarely, however,self-inflicted injury from playing with a sharp object can occur. The objective of this report was to present an unusual injury from a nail that the patient was playing with. Case Report: A 7 year-old, right-handed primary two pupil presented to our center with a 2-hour history of a 6-inch nail on the head. He fell over a 6-inch nail he was holding while playing. The boy gave an account of what happened at presentation. There was no focal neurological deficit. Skull X-ray showed an orbito-cranial radio-opaque nail through the orbit. He was placed on anticonvulsant, antibiotics, and full course of tetanus prophylaxis. Neither computed tomography scan nor angiography could be done. The nail was removed successfully by craniotomy. He had an 8-week course of intravenous and oral antibiotics and had 2-year course of anticonvulsant. He has been followed up for 2 years without complications. Conclusion: Although penetrating brain injuries are common worldwide, we present the peculiar accidental injury in a child who was managed with a good outcome.