Transorbital nonmissile penetrating brain injury: Report of two cases

Figure 1 Physical and imaging examinations of case 1. A: An exposed wooden foreign body, 0.8 cm in diameter, was observed in the right inferior orbital wall accompanied by blood exudation; B: The left pupil, with a history of trauma, was elliptic, with a long diameter of 5.0 mm and a short diameter of 3.0 mm; C and D: Head computed tomography showed a strip of low-density shadow under the right eyeball, entering the brain through the orbital apex and lateral orbital apex. The optic nerve was compressed. The lateral rectus was distorted and displaced.

Figure 2 Physical and imaging examinations of case 2. A: A bone-plate-like foreign body in the left orbit penetrated the skull, with a fractured end exposed, and it was accompanied by an 8 cm-long blepharal laceration; B and C: A low-density foreign body was seen penetrating the skull in the left superior orbital wall, accompanied by interorbital and supraorbital fracture.

Figure 3 Preoperative computed tomography-angiography images showing that there was no obvious abnormal vascular injury (A) and that the intracranial vessel walked normally (B).

Figure 4 Treatment of case 1. A: A black and brown long wooden foreign body was embedded in the brain tissue to a depth of approximately 1 cm; B: A dark brown wooden foreign body approximately 10.5 cm long was removed during the operation; C and D: Postoperative head computed tomography showed complete removal of the foreign body without secondary bleeding.

Figure 5 Treatment of case 2. A: A bone-plate-like foreign body was located in the frontal fossa in the surgical field; B: A plastic, bone-plate-like foreign body, measuring approximately 3.0 cm × 3.5 cm × 0.3 cm, was removed during the operation; C and D: Postoperative head computed tomography showed complete removal of the foreign body without secondary bleeding.

Figure 6 Timeline of case 1. ICU: Intensive care unit.

Figure 7 Timeline of case 2. ICU: Intensive care unit.