Unlabelled: A 39-year-old woman sustained a self-inflicted transorbital penetrating injury that resulted in direct pituitary injury with hypopituitarism and decreased vision in the opposite eye. Several hormone deficiencies were detected. Even though this patient did not develop any other complications from her injury (abscess, cerebrospinal fluid fistula or pseudoaneurysm), after two years of follow-up no recovery of pituitary or visual function has occurred.
Conclusion: From our experience in this case, we propose a conservative multidisciplinary approach when dealing with this type of lesion. Broad spectrum antibiotic coverage and early detection and replacement of any hormone deficiency should be instituted.
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J Neurol Surg B Skull Base
June 2024
Division of Orbital and Ophthalmic Plastic Surgery, Jules Stein Eye Institute, University of California, Los Angeles, California, United States.
We completed a prospective human cadaveric study to determine the ability of a ball bearing (BB) pellet to penetrate the orbit and/or surrounding structures. A single trained sergeant officer discharged an alloy steel air rifle to eight cadaver orbits from four adult human cadaver heads. Five BB pellets each were aimed at three locations (caruncle, upper eyelid, or lower eyelid) at 10 cm and 1 m, and then less specifically, at the orbital region for 3- and 5-m distances.
View Article and Find Full Text PDFKorean J Neurotrauma
September 2023
Department of Neurosurgery, Uijeongbu St. Mary's Hospital, School of Medicine, The Catholic University of Korea, Seoul, Korea.
Objective: Penetrating brain injury occurs when an object enters the skull and pierces the brain. These injuries can damage small or large parts of the brain, are life-threatening, and require emergency care. This study is a summary of penetrating head injuries at our hospital and an analysis of their treatments and prognoses.
View Article and Find Full Text PDFChilds Nerv Syst
September 2023
Department of Pediatrics, Division of Neurosurgery, Texas Tech University Health Sciences Center, 3601 4th Street, Lubbock, TX, 79430, USA.
Penetrating brain injury (PBI) is a subtype of traumatic brain injury (TBI) that has been steadily increasing in prevalence and causing significant mortality in trauma patients. In an emergent setting, it is important to determine the mechanism of injury and decide whether a PBI or a blunt TBI has occurred in order to guide diagnostic imaging and subsequent treatment. In cases where a PBI has been likely or has occurred, it is important to initiate treatment expeditiously as rapid interventions have been shown to lead to better outcomes.
View Article and Find Full Text PDFSurg Neurol Int
February 2023
Department of Neurological Surgery, Juntendo University Urayasu Hospital, Urayasu, Japan.
Background: To the best of our knowledge, there are no reports of penetrating orbitocranial injury (POCI) caused by a shoji frame.
Case Description: A 68-year-old man fell in his living room and was stuck headfirst by a shoji frame. At presentation, marked swelling was noted in the right upper eyelid, with the edge of the broken shoji frame exposed superficially.
Surg Neurol Int
January 2023
Department of Neurosurgery, University of Cincinnati, Cincinnati, United States.
Background: Transorbital (Orbito-cranial) injuries are uncommon, but they are among the most debilitating types of traumatic brain injury (TBI), mainly caused by high-velocity gunshot wounds. In addition, the management of transorbital TBI is well documented in the literature. In contrast, the cranio-orbital migration of a bullet following TBI is rarely reported.
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