Hegde Vijay, Appaswamy Shivashankar, Ahluwalia Harpreet
Ophthalmology Department, Aberdeen Royal Infirmary, Aberdeen, United Kingdom.
Ophthalmic Plast Reconstr Surg. 2005 Nov;21(6):467-9. doi: 10.1097/01.iop.0000181348.64958.da.
A 37-year-old man presented to the emergency department with a visor impacted in the left orbit after a motorbike accident. His initial injury appeared to be limited to the orbit. Because the bleeding appeared disproportionate to the orbital injury, an intracranial injury was suspected. Subsequently, on hemicraniotomy, the tip of the visor was found at the bifurcation of the internal carotid artery. The avulsed upper eyelid was found under the frontal lobe. The patient underwent the clipping of internal carotid artery and middle and anterior cerebral artery with replantation of the upper eyelid. Neurologic damage was limited to loss of vision, right foot drop, and bowel and bladder incontinence. This case of penetrating orbital trauma demonstrates that the absence of focal neurologic deficit and radiologic signs suggestive of intracranial injury may not rule out life-threatening intracranial injury.
一名37岁男性在摩托车事故后因遮阳板嵌入左眼眶而被送往急诊科。他最初的损伤似乎仅限于眼眶。由于出血与眼眶损伤不成比例，怀疑有颅内损伤。随后，在进行半颅骨切开术时，发现遮阳板尖端位于颈内动脉分叉处。撕脱的上眼睑位于额叶下方。患者接受了颈内动脉及大脑中动脉和前动脉的夹闭术，并进行了上眼睑再植。神经损伤仅限于视力丧失、右脚下垂以及大小便失禁。这例穿透性眼眶创伤病例表明，没有局灶性神经功能缺损以及提示颅内损伤的放射学征象并不能排除危及生命的颅内损伤。
