Parajuli Anil, Bastola Jyoti, Shrestha Gulshan Bahadur, Shrestha Jyoti Baba
Nepal J Ophthalmol. 2015 Jul;7(14):186-90. doi: 10.3126/nepjoph.v7i2.14977.
Ocular trauma is a major cause of visual morbidity.
To present a rare case of transorbital intracranial injury extending up to the left internal carotid artery (ICA) with no other systemic neural deficit except for the ocular manifestations.
A 14-year-old female presented to our out-patient department (OPD) with the history of trauma to her left eye with stumps of bamboo shoots secondary to a fall injury. Examination and investigations revealed a foreign body extending from left inferior conjunctival fornix into the intracranial cavity, occluding the various segments of left ICA. The patient subsquently underwent craniotomy and foreign body removal by a combined team of neurosurgeons and ophthalmologists. On discharge, the patient had slight improvement in extraocular motility of her left eye. However the trauma rendered the affected eye, non-seeing.
The intracranial extent of a foreign body entering the cranium via the transorbital route cannot be judged merely by the clinical findings of the nervous system and ocular examination. These patients need timely management by the combined effort of ophthalmologists, neurosurgeons and radiologists.
眼外伤是导致视力损害的主要原因。
报告1例经眶颅内损伤累及左颈内动脉（ICA）的罕见病例，除眼部表现外无其他全身神经功能缺损。
一名14岁女性因跌倒致左眼被竹笋残端刺伤前来我院门诊就诊。检查和调查发现有一异物从左下结膜穹窿延伸至颅内腔，阻塞左ICA各段。患者随后接受了神经外科医生和眼科医生联合团队进行的开颅手术及异物取出术。出院时，患者左眼眼外肌运动略有改善。然而，此次外伤导致患眼失明。
不能仅凭神经系统的临床表现和眼部检查来判断经眶途径进入颅骨的异物的颅内范围。这些患者需要眼科医生、神经外科医生和放射科医生共同努力进行及时治疗。
