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一例极其罕见的病例:木质异物经眼眶穿透性颅脑损伤。病例报告。

An extremely rare case: Transorbital penetrating intracranial injury by wooden foreign body. Case report.

作者信息

Zaky Ahmad, Islam Andi Asadul, Rosyidi Rohadi Muhammad

机构信息

Faculty of Medicine, Muhammadiyah Makassar University, Departement of Neurosurgery, Medical Faculty of Hasanuddin University, Makassar, Indonesia.

Faculty of Medicine, Muhammadiyah Makassar University, Makassar, Indonesia.

出版信息

Ann Med Surg (Lond). 2021 Oct 14;71:102937. doi: 10.1016/j.amsu.2021.102937. eCollection 2021 Nov.

Abstract

INTRODUCTION AND IMPORTANCE

Transorbital Penetrating Intracranial Injury (TOPI) is a rare case, but those caused by Wooden Foreign Body are even challenging that may pose unusual diagnostic and surgical challenges.

CASE PRESENTATION

we presented a TOPI following a wood penetrated to the left temporal fossa region via orbital roof due to struck the tree branches while got a motor vehicle accident. The patient was fully conscious with decreased visual acuity in the left eye and left ophthalmoplegia. Non-contrast CT scan showed the linear-shaped foreign body, air mimicking that penetrated medial orbit plane to the left temporal fossa.

CLINICAL DISCUSSION

The surgery was performed with a temporobasal approach and revealed good results with only mild ophthalmologic complications without long-term fatal complications (1-year followed-up).

CONCLUSION

early removal of wooden foreign body that penetrates to the intracranial via transorbital is mandatory and should be involved multidisciplinary approach to get the optimal result and avoid the fatal complication both neurologically or ophthalmologically.

摘要

引言与重要性

经眶穿透性颅内损伤(TOPI)是一种罕见病例,但由木质异物导致的此类损伤更具挑战性,可能带来非同寻常的诊断和手术难题。

病例介绍

我们呈现了一例经眶穿透性颅内损伤病例,患者因在机动车事故中撞到树枝,致使木头经眶顶穿透至左颞窝区域。患者意识清醒,左眼视力下降且伴有左眼球麻痹。非增强CT扫描显示呈线状的异物,类似空气影,从眶内侧平面穿透至左颞窝。

临床讨论

采用颞底部入路进行手术,结果良好,仅出现轻微眼科并发症,无长期致命并发症(随访1年)。

结论

对于经眶穿透至颅内的木质异物,必须尽早取出,且应采用多学科方法以获得最佳结果,避免神经或眼科方面的致命并发症。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c77f/8528685/3290a1887dbc/gr1.jpg

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