J Korean Neurosurg Soc.  2012 Oct;52(4):414-416. 10.3340/jkns.2012.52.4.414.

Transorbital Penetrating Intracranial Injury by a Chopstick

Affiliations
  • 1Department of Neurosurgery, Yeungnam University College of Medicine, Daegu, Korea. shkim@med.yu.ac.kr

Abstract

A 38-year-old man fell from a chair with a chopstick in his hand. The chopstick penetrated his left eye. He noticed pain, swelling, and numbness around his left eye. On physical examination, a linear wound was noted at the medial aspect of the left eyelid. Noncontrast computed tomography (CT) study showed a linear hypodense structure extending from the medial aspect of the left orbit to the occipital bone, suggesting a foreign body. This foreign body was hyperdense relative to normal parenchyma. From a CT scan with 3-dimensional reconstruction, the foreign body was found to be passing through the optic canal into the cranium. The clear plastic chopstick was withdrawn without difficulty. The patient was discharged home 3 weeks after his surgery. A treatment plan for a transorbital penetrating injury should be determined by a multidisciplinary team, with input from neurosurgeons and ophthalmologists.

Keyword

Penetrating; Foreign body; Orbit; Craniocerebral trauma

MeSH Terms

Adult
Craniocerebral Trauma
Eye
Eyelids
Foreign Bodies
Hand
Humans
Hypesthesia
Occipital Bone
Orbit
Physical Examination
Plastics
Skull
Plastics

Figure

  • Fig. 1 The remarkably swollen left eyelid and a small laceration at upper medial epicanthal area of the left eye are presented.

  • Fig. 2 A, B and C : A noncontrast CT study shows a linear hyperdense structure extending from the medial aspect of the left orbit to the occipital bone, suggesting a foreign body that was hyperdense relative to normal parenchyma. D and E : A CT scan with 3-dimensional reconstruction shows foreign body going through the optic canal into the cranium.

  • Fig. 3 Intraoperative photograph shows the plastic chopstick, at about 14 cm in length. Chopstick was removed surgically.

  • Fig. 4 A : Axial T2-weighted MR image shows a hyperintense linear lesion injury from a chopstick. B : CISS image revealed that left facial nerve was not injured. MR : magnetic resonance, CISS : constructive Interference in Steady State.


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