Fatal intracranial extension of an orbital umbrella stab injury.

We examined a patient with an orbital stab injury with fatal intracranial extension in whom the initial emergency examination did not reveal the extent of damage. Ophthalmologic consultation showed an afferent pupillary defect (Marcus-Gunn pupil), which prompted radiologic studies. Orbital tomograms and computerized tomography demonstrated an optic canal fracture and penetration to the contralateral right ventricle. Diabetes insipidus and thermal irregularity developed, and death occurred seven days later.