Surgical treatment of a transorbital penetrating brain injury

Abstract

Wellingson Silva Paiva, Bernardo Monaco, Marcelo Prudente, Matheus Schimidt Soares, Robson Luis Oliveira de Amorim, Almir Ferreira de Andrade, Manoel Jacobsen TeixeiraDivision of Neurosurgery, Hospital Das Clinicas University of Sao Paulo Medical School, Sao Paulo, BrazilAbstract: Penetrating injury of the skull and brain are relatively uncommon events, representing about 0.4% of all head injuries. Transorbital penetrating brain injury is an unusual occurrence in emergency practice and presents with controversial management. We report the case of a 10-year-old boy who fell forward on a bamboo stick while playing with other children, causing a penetrating transorbital injury, resulting in meningitis. We performed a combined surgical approach with neurosurgeons and ophthalmogic surgeons. Upon discharge, the patient had a Glasgow Coma Scale score of 15, no motor deficit and no visual loss. We discuss the management of this case and review current literature.Keywords: transorbital penetrating brain injury, brain trauma, penetrating head trauma