Hospital of Neurosurgery, Freiburg University Medical Center, Breisacher Strasse 64, 79106 Freiburg, Germany.
Forensic Sci Int. 2009 Dec 15;193(1-3):47-55. doi: 10.1016/j.forsciint.2009.09.001. Epub 2009 Sep 22.
Facial impalement injuries involve the danger of diagnostic pitfalls. Even if the penetrating object extends into the cranial cavity, the clinical symptoms and the radiological signs may be uncharacteristic. In order to illustrate the diagnostic problems, two cases of accidental impalement are reported. In both of them, a wooden foreign body penetrated via the orbita into the cranium and remained undetected at first. Imaging by CT and MRI is presented and compared with regard to the respective diagnostic validity of these methods. Due to its specific anatomic configuration, the orbita constitutes a predilective pathway for low-velocity foreign bodies entering the skull. Based on the clinical data and the radiological findings, transorbital impalement wounds inflicted by wooden objects are discussed under neurosurgical and medicolegal aspects.
面部贯穿伤涉及诊断陷阱的危险。即使穿透物延伸到颅腔，临床症状和放射学征象也可能没有特征。为了说明诊断问题，报告了两例外伤性贯穿伤的病例。在这两个病例中，一个木制异物都通过眶腔穿透颅骨，最初未被发现。介绍了 CT 和 MRI 的影像学表现，并就这些方法各自的诊断有效性进行了比较。由于眼眶的特殊解剖结构，眼眶是低速进入颅骨的异物的首选途径。基于临床资料和影像学发现，从神经外科和法医学角度讨论了木制异物造成的经眶贯穿伤。
