Department of Neurosurgery, Shinshu University School of Medicine, Matsumoto, Japan.
Department of Ophthalmology, Shinshu University School of Medicine, Matsumoto, Japan.
Nagoya J Med Sci. 2023 Feb;85(1):179-184. doi: 10.18999/nagjms.85.1.179.
Penetrating head injury is a relatively rare condition associated with high morbidity and mortality. Although the immediate treatment of penetrating head injury is needed, surgical strategies are varied based on the trajectory of the penetrating objects in the cranium. We present a case of 24-year-old man who sustained a transorbital penetrating injury caused by a wooden chopstick. Neuroimages revealed a linear lesion extending from the left intraorbital segment to the cavernous sinus passing through the superior orbital fissure. The foreign body was successfully removed via the transcranial approach without complications. A careful management based on the perioperative images and correct diagnosis is necessary to avoid unfavorable complications. Four cases of transorbital penetrating injuries have been previously reported, in which the foreign body penetrated through the superior orbital fissure and lodged in the cavernous sinus. The frontotemporal craniotomy with extradural approach can be a useful option to remove foreign bodies around the cavernous sinus regions.
穿透性颅脑损伤是一种相对罕见的疾病，发病率和死亡率均较高。虽然需要立即治疗穿透性颅脑损伤，但手术策略因颅骨内穿透物体的轨迹而异。我们报告了一例 24 岁男性，因木制筷子而导致眶内穿透性损伤。神经影像学显示从左眼眶内段延伸至海绵窦的线性病变，穿过眶上裂。通过经颅入路成功取出异物，无并发症。需要根据围手术期图像和正确诊断进行仔细管理，以避免不利的并发症。以前曾报道过 4 例经眶穿透性损伤病例，其中异物穿过眶上裂并嵌顿在海绵窦内。额颞部开颅术伴硬膜外入路是一种有用的选择，可以去除海绵窦区域周围的异物。
