Indian Journal of Neurotrauma 2017; 14(02/03): 145-148
DOI: 10.1055/s-0038-1649284
Case Report
Thieme Medical and Scientific Publishers Private Ltd.

Civilian Occult Orbitocranial Penetrating Injury Presenting with Cerebral Abscess in Elderly Patient

Mazhar Mulla
1   Department of Neurosurgery, LTMG Hospital, Sion, Mumbai, India
,
Bhagyashri Bhende
1   Department of Neurosurgery, LTMG Hospital, Sion, Mumbai, India
,
Swapnil Patil
1   Department of Neurosurgery, LTMG Hospital, Sion, Mumbai, India
,
Aditya Patil
1   Department of Neurosurgery, LTMG Hospital, Sion, Mumbai, India
,
Batuk Diyora
1   Department of Neurosurgery, LTMG Hospital, Sion, Mumbai, India
› Author Affiliations
Further Information

Publication History

Received: 12 October 2017

Accepted: 04 December 2017

Publication Date:
15 May 2018 (online)

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Abstract

Orbital penetrating injuries are uncommon and occur following accidental entry of objects through orbit. The authors report an interesting case of right frontal abscess resulting from orbitocranial penetrating injury due to accidental penetration of wooden stick into the right eye, which remained undiagnosed. A 70-year-man presented with complaints of headache and vomiting for few days. His computed tomographic (CT) scan of the brain revealed peripheral rim-enhancing cystic lesion in the right frontal lobe with perilesional edema, mass effect, and midline shift. Orbital CT scan revealed hyperdense lesion just lateral to medial orbital wall. Magnetic resonance imaging of the brain showed cystic peripheral rim-enhancing lesion that was homogenous hypointense on T1-weighted images and homogenous hyperintense on T2-weighted images. The patient underwent right frontal craniotomy. Pus was drained out, and abscess wall was excised. Foreign bodies protruding through fractured orbital roof were found and removed. He made good clinical recovery. He has received intravenous antibiotics for 2 weeks followed by 4 weeks of oral antibiotics. He had no visual symptoms. The authors report the case, review the literature, and highlight need for imaging in every case of orbital penetrating injury to prevent the life-threatening cerebral parenchymal complications.