Transorbital Penetrating Head Injury Research Articles

Transorbital penetrating head injury with a favorable outcome: illustrative case

Transorbital penetrating head injuries (PHIs) are uncommon but can lead to substantial deficits, depending on intracranial involvement and the neuroanatomical structures affected. Complete recovery after such injuries is rare. A 7-year-old boy sustained a PHI when he fell onto a garden spike while climbing a fence. Initial imaging showed an orbital roof fracture, focal subarachnoid hemorrhage, and an intraparenchymal hemorrhage in the right frontal lobe with associated linear tract extending to the contralateral superior temporal gyrus. Relevant neuroanatomical structures, including the anterior cerebral arteries (ACAs) and the basal ganglia, were spared. This is in keeping with superior transorbital PHI caused by a garden spike, which had transgressed the skull entering from the right superior orbit. Clinically, he experienced some transient right-sided weakness and mild speech disturbance. Some questionable vasospasm of the ACAs observed on interim magnetic resonance imaging was absent in a repeat imaging study, followed by an unremarkable radiographic follow-up at 6 months after injury. At 18 months after injury, he is neurologically intact without deficit. Most PHIs bear serious lifelong consequences, but here was a case of a deep, penetrating object that managed to avoid all significant neuroanatomical pathways, leading to complete recovery in follow-up.

A case of transorbital penetrating head injury by the broken blade of a powered lawn trimmer

A case of transorbital penetrating head injury by the broken blade of a powered lawn trimmer

Transorbital Penetrating Head Injury (TOPHI): Short Series of Two Cases with Review of Literature

Transorbital Penetrating Head Injury (TOPHI): Short Series of Two Cases with Review of Literature

WITHDRAWN: Trans-orbital penetrating head injury (TOPHI): Short series of two cases with review of literature

WITHDRAWN: Trans-orbital penetrating head injury (TOPHI): Short series of two cases with review of literature

WITHDRAWN: Trans-orbital penetrating head injury

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Instantaneous Death Due to Transorbital Reverse Penetration of a Screw in an Accidental Fall

We present a peculiar autopsy case of a transorbital penetrating head injury, in a male worker, after an accidental fall onto a screw not completely stuck into a wooden board. A 13-cm screw entered the cranium 9.5 cm deep, penetrating with the flat end, a condition defined in literature as "reverse penetration." The death was instantaneous and caused by a neurogenic shock due to injuries to the brain stem and the right cerebellar hemisphere. These injuries, enabled by the length of the screw, are generally described in literature as due to nontransorbital penetrations, frequently associated with posterior entry and a large intracranial injury. The ocular globe has been, furthermore, perfectly preserved thanks to its mobility in the orbit. Even the dynamic of the incident is peculiar because of the stationary nature of the penetrating object, which the victim actively fell on by accident. To the best of our knowledge, the matter is therefore a very peculiar mortal case of transorbital intracranial penetration, whose verified injuries and dynamics are absolutely atypical. The case is now under discussion, and a review of pertinent literature is performed.

Trans-orbital penetrating head injury (TOPHI): Short series of two cases with review of literature

Penetrating head injury of brain is uncommon form of external compound injury account for nearly 0.4% of head injuries. Transorbital penetrating head injuries (TOPHI) are still rarer Authors report two cases, first reported immediately caused by ceramic stone while second after lapse of three months following injury due to wooden twig, both underwent surgery with removal of foreign body with good outcome. Proper clinical history, examination and CT scan to evaluate trajectory and CT angiography to assess vascular anatomy are prerequisite for proper planning and management. Management of such cases and pertinent literature is reviewed.

Transorbital penetrating head injury by a toilet brush handle

Transorbital penetrating brain injuries are rare lesions without defined therapy standards. A male patient presented at our institution with a toilet brush handle in the right cerebral hemisphere. CT imaging identified the object entering the right orbit and having crossed the right hemisphere in the ventricular plane. After performing a medium-sized craniotomy, the object was removed step-by-step under monitoring with an intraoperative CT scan to ensure no involving major hemorrhage. Transorbital penetrating brain injuries are treated best by utilizing all up-to-date technical developments such as intraoperative CT-scanning to increase the safety in the management of such exceptional lesions with increased risk of immediate life-threatening intracranial bleeding.

Fatal transorbital head injury by bicycle brake handle

Accidental transorbital head injuries are quite rare. Penetrating head injuries by blunt objects are possible when the site of penetration is through the orbit or the thin temporal bone. The present case is a rare case of transorbital penetrating head injury by a blunt object – bicycle brake handle. Minor external wounds may be misleading and fatal consequences may ensue if cerebral damage is missed on diagnosis. Proper antibiotic coverage to prevent meningitis and neurosurgical intervention can reduce mortality in such cases.

Trans-orbital penetrating head injury with a door key

We report a unique case of transorbital penetrating head injury with a door-key. The case highlights the difficulties of preoperative ophthalmological assessment in the presence of a retained object and discusses the management of this and related injuries.

Transorbital penetrating head injury with a hunting arrow: Case report

The development of more complex and diverse hunting weapons may result in an increase of uncommon forms of penetrating injury to the brain. We present a case of non-fatal transorbital arrow injury to the brain. High velocity projectile injuries merit certain management adaptations from gunshot or low velocity stab wounds. This case highlights the necessity for anterograde removal of the arrow in the direction of its line of trajectory. Early assessment of the patient with cerebral angiography to identify surgically correctable vascular injury is recommended.