title: Transorbital penetrating head injury by a toilet brush handle.
abstract: BACKGROUND
  Transorbital penetrating brain injuries are rare lesions without defined therapy standards.
  
  
  METHODS
  A male patient presented at our institution with a toilet brush handle in the right cerebral hemisphere. CT imaging identified the object entering the right orbit and having crossed the right hemisphere in the ventricular plane. After performing a medium-sized craniotomy, the object was removed step-by-step under monitoring with an intraoperative CT scan to ensure no involving major hemorrhage.
  
  
  CONCLUSIONS
  Transorbital penetrating brain injuries are treated best by utilizing all up-to-date technical developments such as intraoperative CT-scanning to increase the safety in the management of such exceptional lesions with increased risk of immediate life-threatening intracranial bleeding.
authors.affiliation: Department of Neurosurgery, University of Heidelberg, Im Neuenheimer Feld 400, 69120 Heidelberg, Germany. mohammad.farhadi@med.uni-heidelberg.de
authors.forename: M R
authors.initials: MR
authors.lastname: Farhadi
authors.forename: M
authors.initials: M
authors.lastname: Becker
authors.forename: C
authors.initials: C
authors.lastname: Stippich
authors.forename: A W
authors.initials: AW
authors.lastname: Unterberg
authors.forename: K L
authors.initials: KL
authors.lastname: Kiening
mesh_terms: D000058:Accidental Falls; D001921:Brain / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery; D001922:Brain Abscess / Q000000981:diagnostic imaging / Q000209:etiology / Q000473:pathology; D001930:Brain Injuries / Q000000981:diagnostic imaging / Q000209:etiology / Q000473:pathology*; D020202:Cerebral Hemorrhage, Traumatic / Q000000981:diagnostic imaging / Q000517:prevention & control / Q000601:surgery; D003399:Craniotomy; D019299:Decompression, Surgical; D004185:Disability Evaluation; D004827:Epilepsy / Q000150:complications; D005547:Foreign Bodies / Q000000981:diagnostic imaging / Q000473:pathology* / Q000601:surgery; D020197:Head Injuries, Penetrating / Q000000981:diagnostic imaging / Q000209:etiology / Q000473:pathology*; D006801:Humans; D007431:Intraoperative Complications / Q000000981:diagnostic imaging / Q000209:etiology / Q000517:prevention & control; D008297:Male; D008875:Middle Aged; D016343:Monitoring, Intraoperative / Q000379:methods*; D009917:Orbital Fractures / Q000000981:diagnostic imaging / Q000209:etiology / Q000473:pathology*; D014057:Tomography, X-Ray Computed / Q000379:methods*; D016896:Treatment Outcome