Journal Information
Vol. 20. Issue 5.
Pages 467-469 (January 2009)
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Vol. 20. Issue 5.
Pages 467-469 (January 2009)
Orbitocerebral injury by a knife: case report
Traumatismo perforante orbito-craneal por un cuchillo de pan. Presentación de un caso
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1414
O. Okay, E. Dağlioğlu
, C. Ozdol, O. Uckun, A. Dalgic, F. Ergungor
Ankara Numune Education and Research Hospital. Neurosurgery Clinics. Ankara. Turkey
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Summary

Orbital penetrating injuries may cause significant harm to the optic nerves and eyeball as well as to the brain and cerebral vessels. Management of orbital foreign bodies should include prompt recognition of the extent of the injury, broad-spectrum parenteral antibiotics, tetanus prophylaxis, anticonvulsant medication and early surgical intervention under direct vision to remove the foreign body and to avoid immediate and long-term complications. We report a penetrating orbital injury caused by a bread knife that extended from the orbit to the tegmental dura mater of the temporal bone. The knife's main trajectory coursed through the temporal lobe. Adjacent cerebral structures were explored before removal of the knife.

Key words:
Cerebrum
Eyeball
Orbit
Cranial penetrating injury
Knife
Resumen

Los traumatismos perforantes orbitarios suelen causar un daño importante al nervio óptico y globo ocular, así como al cerebro y vasos cerebrales. La órbita permite un acceso fácil hacia la cavidad craneal debido a que tiene una pared ósea delgada y a la presencia del agujero óptico. El enfoque terapéutico de los traumatismos orbitarios por cuerpo extraño depende fundamentalmente del tipo de traumatismo y del cuerpo extraño. El tratamiento de este tipo de lesiones incluirá un rápido diagnostico de la magnitud del daño ocasionado, el empleo por vía parenteral de antibióticos de amplio espectro, profilaxis del tétanos, medicación anticonvulsivante y cirugía urgente que permita, bajo visión directa, la extracción del cuerpo extraño, a fin de evitar complicaciones inmediatas o a largo plazo. Presentamos el caso de un traumatismo perforante ocular ocasionado por un cuchillo de pan que se extendía desde la órbita hasta el tegmentum del hueso temporal. El cuchillo seguía una trayectoria directa a través del lóbulo temporal. Se practicó una exploración quirúrgica de las estructuras cerebrales adyacentes para poder extirpar el cuchillo. Se revisan y analizan las opciones de tratamiento de los traumatismos perforantes de la órbita.

Palabras clave:
Cerebro
Cuchillo
Globo ocular
Orbita
Traumatismo perforante craneal

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