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      Occult Orbitocranial Penetrating Pencil Injury in a Child

      case-report
      Author(s): 1 , 2 , *
      Publication date (Electronic):
      Journal: Case Reports in Surgery
      Publisher: Hindawi Publishing Corporation

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          Abstract

          Transorbital slow-penetrating injury is an uncommon type of head injury that is seen more often in the pediatric age group. This type of injury can be occult, which is often associated with serious complications. We report on a 4-year-old female who presented with orbital swelling after an unwitnessed right orbital injury following a fall on her face at her school. Three days after injury, the presence of a foreign body was discovered on imaging study when she presented with orbital swelling and purulent discharges. She recovered well after surgical and medical management. This paper sheds light on the importance of high suspicion for the presence and early surgical management of a penetrating foreign body.

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          Patterns of transorbital intracranial injury: a review and comparison of occult and non-occult cases.

          Roger E Turbin, Dawn Maxwell, Paul Langer … (2015)
          The authors present an illustrative case of occult transorbital penetrating intracranial injury in a child, and review the literature concerning patterns of low-velocity, non-projectile injury during the era of modern CT and MRI study. Review of the mechanism of injury and analysis of surface entry site of penetration in 38 cases suggests recurring patterns of injury in occult and non-occult cases. A classification system based on surface entry zone site is applied to these injuries. Knowledge of the classification system should increase clinical suspicion for this type of often occult, penetrating orbito-cranial injury and direct appropriate investigation to provide earlier detection and diagnosis of the transorbital, intracranial penetration.
          Article 0 comments Cited 30 times – based on 0 reviews     Review now
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            The danger of intracranial wood.

            J Brodkey, B J Colombi, Jeff Miller (1977)
            Peri-orbital puncture wounds by sharp wooden objects are not rare, but can be dangerous when there is intracranial penetration by and retention of the wooden foreign body. Days to years after an apparently trivial initial wounding, serious intracranial complications can occur. The authors have reviewed 42 case reports from the literature. Morbidity-defined as permanent neurologic sequelae-occurred in 74% of the cases. Intracranial suppuration was the major complication, with brain abscess having occurred in nearly one-half of the cases. Mortality occurred in 25% of 28 cases occurring in the post-antibiotic era. The qualities of wood which make it especially hazardous as a wounding agent and foreign body are discussed. The role of orbital anatomy in affording easy access to the cranial contents is described. Surgical exploration in all those cases in which there is a reasonable suspicion of intracranial injury is recommended.
            Article 0 comments Cited 27 times – based on 0 reviews     Review now
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              Transorbital penetrating injury by a chopstick--case report.

              Y Murao, M Hata, K Okuchi … (2001)
              A one-year-old boy presented with orbitocranial penetrating injury by a chopstick. Neurological examination did not reveal abnormal findings. Skull radiography did not reveal any sign of fracture and there were no abnormal findings. Initially, computed tomography (CT) of the head did not reveal any intracranial lesions. However, bone window CT showed a well-defined low-density abnormality measuring 2.5 cm in length in the right orbit and parasellar region. Magnetic resonance imaging clearly revealed a low-intensity structure extending from the orbit to the prepontine area. Surgical exploration was emergently performed and the wooden fragment was removed. The postoperative course was uneventful. Transorbital penetrating injury by a wooden foreign body is relatively rare. The wound may be superficial and trivial. Major neurological deficit does not usually manifest immediately, so the penetrating injury may be overlooked. If the foreign body is retained in the orbit and cranium, severe infectious complications may occur later.
              Article 0 comments Cited 15 times – based on 0 reviews     Review now
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                Author and article information

                Journal
                Journal ID (nlm-ta): Case Rep Surg
                Journal ID (iso-abbrev): Case Rep Surg
                Journal ID (publisher-id): CRIM.SURGERY
                Title: Case Reports in Surgery
                Publisher: Hindawi Publishing Corporation
                ISSN (Print): 2090-6900
                ISSN (Electronic): 2090-6919
                Publication date (Print): 2012
                Publication date (Electronic): 4 December 2012
                Volume: 2012
                Electronic Location Identifier: 716791
                Affiliations
                1Division of Neurological Surgery, Neurosciences Department, King Faisal Specialist Hospital and Research Center, Riyadh 11211, Saudi Arabia
                2Division of Neurological Surgery, Faculty of Medicine, King Abdulaziz University, P.O. Box 3354, Jeddah 21589, Saudi Arabia
                Author notes

                Academic Editors: J. M. Bernal, H. Hirano, and T. Kaido

                Author information
                http://orcid.org/0000-0002-3053-7912
                Article
                DOI: 10.1155/2012/716791
                PMC ID: 3529444
                PubMed ID: 23304618
                SO-VID: 7c86542b-b6bd-4095-9892-55d874d7e612
                Copyright © Copyright © 2012 F. Al-Otaibi and S. Baeesa.
                License:

                This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                Date received : 14 August 2012
                Date accepted : 13 November 2012
                Categories
                Subject: Case Report

                ScienceOpen disciplines: Surgery
                Data availability:
                ScienceOpen disciplines: Surgery

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