Puncture wound of the eyelid causing brain abscess.

A case of brain abscess following an apparently trival puncture wound to the eyelid is presented to emphasize the importance of meticulous examination of eye wounds in children to look for penetration into the cranial vault. Any suggestion of such penetrating injury either by history, examination, or X-ray should dictate neurosurgical consultation, and immediate local culture and debridement of the wound. If nonoperative management is elected, a careful watch must be kept for signs of infection, which dictate early exploration, and broad-spectrum antibiotic coverage of Gram-positive and Gram-negative organisms common to penetrating skull trauma.