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

Abstract

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.

Keywords

Penetrating injury - Transorbital injury - Skull base - Cranio-cerebral injury

• References

• 1 Liu W.-H., Chiang Y.-H., Hsieh C.-T., Sun J.-M., Hsia C.-C.. Transorbital penetrating brain injury by Branchlet: a rare case. J Emerg Med 2011; 41: 482-485
• 2 Satyarthee G., Borkar S., Tripathi A., Sharma B.S.. Transorbital penetrating cerebral injury with a ceramic stone: report of an interesting case. Neurol India 2009; 57: 331
• 3 Kellly D.F., Nikas D.L., Becker D.P.. Diagnosis and Treatment of Moderate and Severe Head Onjuries in Adults. Neurological Surgery. 4th. ed. 1996. WB Saunders; Philadelphia: 1618-1718
• 4 Seex K., Koppel D., Fitzpatrick M., Pyott A.. Trans-orbital penetrating head injury with a door key. J Craniomaxillofac Surg 1997; 25: 353-355
• 5 Nasr A.M., Haik B.G., Fleming J.C., Al-Hussain H.M., Karcioglu Z.A.. Penetrating orbital injury with organic foreign bodies. Ophthalmology 1999; 106: 523-532
• 6 Miller C.F., Brodkey J.S., Colombi B.J.. The danger of intracranial wood. Surg Neurol 1977; 07: 95-103
• 7 Gopalakrishnan M., Indira Devi B.. Fatal penetrating orbitocerebral injury by bicycle brake handle. Indian J Neurotr 2007; 04: 123-124
• 8 Potapov A.A., Eropkin S.V., Kornienko V.N.. et al Late diagnosis and removal of a large wooden foreign body in the cranio-orbital region. J Craniofac Surg 1996; 07: 311-314
• 9 Dadlani R., Ghosal N., Bagdi N., Venkatesh P.K., Hegde A.S.. Chronic brain abscess secondary to a retained wooden foreign body: diagnostic and management dilemmas. Indian J Pediatr 2010; 77: 575-576
• 10 Peterson J.J., Bancroft L.W., Kransdorf M.J.. Wooden foreign bodies: imaging appearance. AJR Am J Roentgenol 2002; 178: 557-562
• 11 Tite D.J., Batstone M.D., Lynham A.J., Monsour F.N.T., Chapman P.J.. Penetrating orbital injury with wooden foreign body initially diagnosed as an orbital floor blowout fracture. ANZ J Surg 2002; 72: 529-530
• 12 Jooma R., Bradshaw J.R., Coakham H.B.. Computed tomography in penetrating cranial injury by a wooden foreign body. Surg Neurol 1984; 21: 236-238
• 13 Peek-Asa C., McArthur D., Hovda D., Kraus J.. Early predictors of mortality in penetrating compared with closed brain injury. Brain Inj 2001; 15: 801-810
• 14 Stephens L.F., Mossop C.M., Bell R.S., Tigno Jr. T., Rosner M.K., Kumar A.. Cranioplasty complications following wartime decompressive craniectomy. Neurosurg Focus 2010; 28 (05) E3
• 15 du Trevou. van Dellen J.R.. Penetrating stab wounds to the brain: the timing of angiography in patients presenting with the weapons already removed. Neurosurgery 1992; 31 (05) 905-912