Department of Neurosurgery, University of Health Sciences, Okmeydani Training and Research Hospital, Istanbul, Turkey.
World Neurosurg. 2019 Sep;129:237-240. doi: 10.1016/j.wneu.2019.06.051. Epub 2019 Jun 15.
Intracranial penetrating traumas (IPTs) are rarely encountered in neurosurgery practice. Here, we report the case of a patient with orbital and cranial trauma caused by an unexpected object.
A 37-year-old male presenting with a right orbital penetrating injury was referred to our emergency department. Neurologic examination of the patient revealed right periorbital ecchymosis, a dilated and fixed right pupil, and right hemiparesis. Cranial computed tomography showed fractures of the right orbital medial wall and the anterior skull base, as well as bifrontal and left parietal intracerebral hemorrhage accompanied by a metallic foreign body artifact. Emergency left frontoparietal decompressive craniectomy was performed, and the foreign body, identified as a fishing sinker, was removed. No additional postoperative complications were observed, and cranioplasty was performed 6 months postoperatively.
IPTs have high morbidity and mortality rates. Early surgical intervention is often the first treatment option. Intracranial injury caused by a fishing sinker is an extremely rare low-energy intracranial penetrating trauma, and in the literature, this is the first reported case in which the patient survived.
颅内穿透性创伤（IPTs）在神经外科实践中很少见。在这里，我们报告了一例由意外物体引起的眼眶和颅脑外伤患者的病例。
一名 37 岁男性因右侧眼眶穿透伤被转至我们的急诊部。患者的神经检查显示右眼周瘀斑、瞳孔扩大且固定、右侧偏瘫。头颅计算机断层扫描显示右侧眶内侧壁和前颅底骨折，以及额骨双侧和顶骨左侧脑内出血，并伴有金属异物伪影。紧急行左额顶开颅减压术，并取出异物，确定为钓鱼铅坠。术后无其他并发症，6 个月后行颅骨修补术。
颅内穿透性创伤的发病率和死亡率都很高。早期手术干预通常是首选治疗方法。钓鱼铅坠引起的颅内损伤是一种极其罕见的低能量颅内穿透性创伤，在文献中，这是首例患者存活的报道。
