Fatal penetrating orbitocerebral injury by bicycle brake handle

Abstract

Accidental penetrating head injuries are rare but significant cause of morbidity in children. We report a case of a nine-year-old who sustained a fatal trans-orbital penetrating injury following a fall from bicycle. The plastic sheath of the metal brake handle was lodged intracranially, injuring the brainstem. The CT scan features and autopsy findings are described.

Keywords

head injury - penetrating head trauma - traumatic subarachnoid hemorrhage

• References

• 1 Peek-Asa C, McArthur D, Hovda D, Kraus J. Early predictors of mortality in penetrating compared with closed brain injury. Brain Inj 15 2001; 801-810
• 2 Faraji M, Ashrafzadeh Farah. Penetrating Head Injuries in Children. Neurosurgery Quarterly 15 2005; 160-163
• 3 Ahmad FU, Suri A, Mahapatra AK. Fatal penetrating brainstem injury caused by bicycle brake handle. Pediatr Neurosurg 41 2005; 226-228
• 4 Ng JD, Payner TD, Holck DE, Martin RT, Nunery WT. Orbital trauma caused by bicycle hand brakes. Ophthal Plast Reconstr Surg 20 2004; 60-63
• 5 Ildan F, Bagdatoglu H, Boyar B, Doganay M, Cetinalp E, Karadayi A. The nonsurgical management of a penetrating orbitocranial injury reaching the brain stem: case report. J Trauma 36 1994; 116-118
• 6 Levy ML, Rezai A, Masri LS, Litofsky SN, Giannotta SL, Apuzzo ML, Weiss MH. The significance of subarachnoid hemorrhage after penetrating craniocerebral injury: correlations with angiography and outcome in a civilian population. Neurosurgery 32 1993; 532-540