Caporlingua Alessandro, Caporlingua Federico, Lenzi Jacopo
Department of Neurology and Psychiatry, Neurosurgery, "Sapienza" University of Rome, Rome, Italy.
Asian J Neurosurg. 2016 Jul-Sep;11(3):309. doi: 10.4103/1793-5482.179641.
Nonmissile orbitocranial penetrating brain injuries are uncommonly dealt with in a civilian context. Surgical management is controversial, due to the lack of widely accepted guidelines. A 52-year-old man was hit in his left eye by a metallic foreign body (FB). Head computed tomography (CT) scan showed a left subcortical parietal FB with a considerable hemorrhagic trail originating from the left orbital roof. Surgical treatment was staged; an exenteratio oculi and a left parietal craniotomy to extract the FB under intraoperative CT guidance were performed at post trauma day third and sixth, respectively. A postoperative infectious complication was treated conservatively. The patient retained a right hemiparesis (3/5) and was transferred to rehabilitation in good clinical conditions at day 49(th). He had suspended antiepilectic therapy at that time. A case-by-case tailored approach is mandatory to achieve the best outcome in such a heterogeneous nosological entity. Case reporting is crucial to further understand its mechanism and dynamics.
非导弹性眶颅穿透性脑损伤在 civilian 环境中较少见。由于缺乏广泛接受的指南，手术管理存在争议。一名52岁男性左眼被金属异物（FB）击中。头部计算机断层扫描（CT）显示左皮质下顶叶有FB，伴有源自左眶顶的大量出血痕迹。手术治疗分阶段进行；分别在创伤后第3天和第6天进行了眼球摘除术和在术中CT引导下的左顶叶开颅术以取出FB。术后感染并发症采用保守治疗。患者遗留右侧偏瘫（3/5），并在第49天以良好的临床状态转至康复治疗。当时他已停用抗癫痫治疗。对于这种异质性疾病实体，必须采用逐案定制的方法以获得最佳结果。病例报告对于进一步了解其机制和动态至关重要。 （注：原文中“civilian context”直译为“平民环境”，在医学语境中可能不太准确，可结合上下文进一步理解其确切含义，但按要求不添加解释。）
