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CASE REPORT
Year : 2016  |  Volume : 11  |  Issue : 3  |  Page : 309

Good outcome after delayed surgery for orbitocranial non-missile penetrating brain injury


Department of Neurology and Psychiatry, Neurosurgery, “Sapienza” University of Rome, Rome, Italy

Correspondence Address:
Dr. Federico Caporlingua
Via del Policlinico 155, 00161 Rome
Italy
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/1793-5482.179641

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Nonmissile orbitocranial penetrating brain injuries are uncommonly dealt with in a civilian context. Surgical management is controversial, due to the lack of widely accepted guidelines. A 52-year-old man was hit in his left eye by a metallic foreign body (FB). Head computed tomography (CT) scan showed a left subcortical parietal FB with a considerable hemorrhagic trail originating from the left orbital roof. Surgical treatment was staged; an exenteratio oculi and a left parietal craniotomy to extract the FB under intraoperative CT guidance were performed at post trauma day third and sixth, respectively. A postoperative infectious complication was treated conservatively. The patient retained a right hemiparesis (3/5) and was transferred to rehabilitation in good clinical conditions at day 49th. He had suspended antiepilectic therapy at that time. A case-by-case tailored approach is mandatory to achieve the best outcome in such a heterogeneous nosological entity. Case reporting is crucial to further understand its mechanism and dynamics.


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