Rahman N U, Jamjoom A, Jamjoom Z A, Abu el-Asrar A
Division of Neurosurgery, College of Medicine, King Saud University, Riyadh, Saudi Arabia.
Int Ophthalmol. 1997;21(1):13-7. doi: 10.1023/a:1005834913614.
Two cases of orbito-cranial injury caused by foreign bodies (FBs) penetrating the lateral wall and roof of the orbit are described. In the first patient, a long rusted nail acted as a missile and was only detected by X-rays and CT scan. The nail penetrated the orbit, the eyeball, the lateral orbital wall, and the temporal lobe of the brain. Lodged partly in the orbit and partly in the brain, this nail caused leakage of cerebrospinal fluid (CSF) through eye and led to orbital cellulitis and localized meningitis. The foreign body (FB) was removed through an extradural pterional approach with rapid resolution of orbital cellulitis and meningitis. In the second patient, large metallic FB, having penetrated the orbital roof was lodged intracranially above the chiasma. This was removed via frontal craniotomy. Mechanism of such injuries and appropriate surgical approaches are described as well.
本文描述了两例因异物穿透眼眶外侧壁和眶顶导致的眶颅损伤病例。第一例患者中，一枚生锈的长钉子充当了投射物，仅通过X射线和CT扫描才被发现。钉子穿透了眼眶、眼球、眶外侧壁和脑颞叶。这枚钉子部分嵌于眼眶，部分嵌于脑内，导致脑脊液通过眼部漏出，引发眶蜂窝织炎和局限性脑膜炎。通过硬膜外翼点入路取出异物后，眶蜂窝织炎和脑膜炎迅速消退。第二例患者中，大型金属异物穿透眶顶后嵌于颅内视交叉上方。通过额部开颅手术将其取出。文中还描述了此类损伤的机制及合适的手术入路。
