Transorbital intracranial penetrating injury from impaling on an earpick.
An inebriated 86-year-old man impaled himself on a wooden earpick that penetrated through the superior orbital fissure into the prepontine cistern. The patient underwent surgery immediately by a lateral suboccipital approach, and the earpick was pulled out through the wound with control of hemorrhage from the cavernous sinus. He survived this event with no neurologic deficits apart from complete ipsilateral ophthalmoplegia and ptosis. Prompt imaging and surgical intervention allowing direct visualization of the foreign body and prevention of intracranial complications are part of proper management of this problem.
Yamashita
Taro
T
Department of Neurosurgery, Sapporo Medical University, Sapporo, Japan.
Mikami
Takeshi
T
Baba
Takeo
T
Minamida
Yoshihiro
Y
Sugino
Toshiya
T
Koyanagi
Izumi
I
Nonaka
Tadashi
T
Houkin
Kiyohiro
K
D000369:Aged, 80 and over; D005129:Eye Foreign Bodies / Q000175:diagnosis* / Q000601:surgery; D005143:Eyelids / Q000293:injuries*; D005500:Follow-Up Studies; D020197:Head Injuries, Penetrating / Q000175:diagnosis* / Q000601:surgery; D006801:Humans; D008297:Male; D019635:Neurosurgical Procedures / Q000379:methods; D009915:Orbit / Q000293:injuries*; D014057:Tomography, X-Ray Computed; D015599:Trauma Severity Indices