Occult orbito-cranial penetrating injury by pencil: role of beta tracer protein as a marker for cerebrospinal fluid leakage.
Orbito-cranial foreign bodies present a treacherous situation that can escape detection. The only evidence of these foreign bodies may be the entry wound in the form of a small lid laceration. A two-year-old boy presented with right upper lid laceration following a fall two hours back. Analysis of the fluid around the wound revealed a beta-tracer protein (beta-TP) value of 33.5 mg/l suggestive of cerebrospinal fluid (CSF). Three-dimensional computed tomography (CT) scan revealed a foreign body measuring 4.2 cm x 0.8 cm passing from the orbital roof to the frontal lobe. The foreign body tract was explored through the eyelid laceration and a broken pencil was removed followed by dural patch graft. The patient developed no ocular or intracranial complications. Beta-TP, a highly specific marker of CSF is routinely used in screening patients of neurosurgery and otolaryngology with CSF leaks, however, its use has never been reported in ophthalmic literature based on an online PubMed search.
Unit for Oculoplasty Surgery, Department of Ophthalmology, Ghent University Hospital, Ghent, Belgium.
Akash D
AD
Shah
Christian
C
Decock
D015415:Biomarkers / Q000134:cerebrospinal fluid; D001930:Brain Injuries / Q000000981:diagnostic imaging* / Q000378:metabolism; D065634:Cerebrospinal Fluid Leak; D002559:Cerebrospinal Fluid Rhinorrhea / Q000000981:diagnostic imaging / Q000378:metabolism*; D002675:Child, Preschool; D005129:Eye Foreign Bodies / Q000000981:diagnostic imaging* / Q000378:metabolism; D015807:Eye Injuries, Penetrating / Q000000981:diagnostic imaging* / Q000378:metabolism; D006801:Humans; D019746:Intramolecular Oxidoreductases / Q000378:metabolism*; D054834:Lipocalins / Q000378:metabolism*; D008297:Male; D009915:Orbit / Q000293:injuries; D014057:Tomography, X-Ray Computed
D015415:Biomarkers; D054834:Lipocalins; D019746:Intramolecular Oxidoreductases; C022466:prostaglandin R2 D-isomerase