[Skullbase-penetrating injuries caused by umbrella tips: case reports].
Two cases of skullbase-penetrating injuries caused by umbrella tips are reported. Case 1: 24-year-old male. Admitted with disturbance of consciousness, left hemiparesis, nasal bleeding, and laceration of left lower eyelid because of having been stabbed by an umbrella tip. Pupils and fundi revealed no definite findings. Plain skull X-ray showed turbid ethmoid sinus and fracture of planum sphenoidale. Cranial CT showed right putaminal hematoma with intraventricular hemorrhage and pneumocephalus. Increased ICP necessitated surgery two days after the injury. Dural laceration of planum sphnoidale, laceration of left optic nerve, right rectal gyrus contusion and rebleeding from the right lenticulostriate branch were observed. Dural plasty and removal of hematoma with external decompression were carried out. He had a good postoperative course, but left visual loss and left hemiparesis remained. Case 2: 29-year-old male. Admitted with excoriation of his right nostril because of having been stabbed by an umbrella tip, severe headache, and nasal discharge. Oculomotor palsy was observed as well as CSF rhinorrhea and meningeal irritability. Plain skull X-ray showed niveau in sphenoidal sinus, pneumocephalus, and fracture of sella turcica. His complaint disappeared after conservative therapy. We reviewed the literature and found only 4 similar cases. The skullbase, because of its anatomical character, is likely to be penetrated in orbital and periorbital injury caused by umbrella tips. Cases which include disturbance of consciousness have a poor prognosis. We hope the fact that umbrella tips can easily become life-threatening objects will come to the attention of the general public so that similar cases may be avoided.
Tokitsu
M
M
Department of Neurosurgery, Kyorin University School of Medicine, Tokyo, Japan.
Nakamura
M
M
Yokoyama
H
H
Watanabe
H
H
Hara
M
M
Takeuchi
K
K
D000328:Adult; D001930:Brain Injuries / Q000150:complications; D002559:Cerebrospinal Fluid Rhinorrhea / Q000209:etiology; D006801:Humans; D008297:Male; D011007:Pneumocephalus / Q000209:etiology; D012658:Sella Turcica / Q000293:injuries; D012887:Skull Fractures / Q000150:complications; D013100:Sphenoid Bone / Q000293:injuries; D014474:Unconsciousness / Q000209:etiology; D014950:Wounds, Penetrating / Q000150:complications