Transorbitary intracranial penetrating injury involving bicycle brake handle: case report and literature review

ABSTRACT Penetrating cranio-orbital injuries are uncommon events and represent a small percentage of cranioencephalic traumas. The clinical condition and surgical management were described by reviewing the patient's electronic medical records. This case reports on a 37-year-old male patient who...

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Main Authors: Paulo Henrique Alves Togni Filho, Roscicler Pereira de Sousa, André Luís Santos Vaz Leite, Bruno Previdelli Coghi, Guilherme Augusto Paro, Guilherme Amantéa Costa Carvalho
Format: Article
Language:English
Published: Sociedade Brasileira de Oftalmologia 2024-11-01
Series:Revista Brasileira de Oftalmologia
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Online Access:http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0034-72802024000100520&lng=en&tlng=en
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author Paulo Henrique Alves Togni Filho
Roscicler Pereira de Sousa
André Luís Santos Vaz Leite
Bruno Previdelli Coghi
Guilherme Augusto Paro
Guilherme Amantéa Costa Carvalho
author_facet Paulo Henrique Alves Togni Filho
Roscicler Pereira de Sousa
André Luís Santos Vaz Leite
Bruno Previdelli Coghi
Guilherme Augusto Paro
Guilherme Amantéa Costa Carvalho
author_sort Paulo Henrique Alves Togni Filho
collection DOAJ
description ABSTRACT Penetrating cranio-orbital injuries are uncommon events and represent a small percentage of cranioencephalic traumas. The clinical condition and surgical management were described by reviewing the patient's electronic medical records. This case reports on a 37-year-old male patient who suffered penetrating trauma to the skull from the brake lever of his bicycle as a result of an accidental fall while cycling. Brought in by the SAMU, the patient had a Glasgow score of 15, a preserved left orbit, while the right orbit showed no eye opening, amaurosis, a non-photo-reagent mydriatic pupil, both to the direct and indirect reflex. A computed tomography scan of the skull showed a metal brake handle lodged in the skull on the right, causing a fracture of the orbital face of the zygomatic and greater wing of the sphenoid, with the end in the orbit. In the operating room, the object was carefully extracted without complications. On the first postoperative day, a magnetic resonance imaging scan was requested, which revealed a hemorrhagic contusion of the temporal lobe on the right side, rupture of the lateral rectus muscle, hematic and gaseous contents inside the orbit, as well as a possible retinal detachment. On the sixth post-operative day, with amaurosis maintained on the right, the patient was discharged and referred for specialized ophthalmological follow-up. Penetrating cranio-orbital trauma has potentially fatal outcomes if not diagnosed and managed early and properly.
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spelling doaj-art-f690a59bbd054b859806e6bccddc9fd52024-11-26T07:46:51ZengSociedade Brasileira de OftalmologiaRevista Brasileira de Oftalmologia1982-85512024-11-018310.37039/1982.8551.20240066Transorbitary intracranial penetrating injury involving bicycle brake handle: case report and literature reviewPaulo Henrique Alves Togni Filhohttps://orcid.org/0009-0007-3817-1728Roscicler Pereira de Sousahttps://orcid.org/0009-0002-7522-5813André Luís Santos Vaz Leitehttps://orcid.org/0009-0002-8315-3485Bruno Previdelli Coghihttps://orcid.org/0000-0002-3951-9040Guilherme Augusto Parohttps://orcid.org/0009-0001-2220-3875Guilherme Amantéa Costa Carvalhohttps://orcid.org/0009-0002-3786-5836ABSTRACT Penetrating cranio-orbital injuries are uncommon events and represent a small percentage of cranioencephalic traumas. The clinical condition and surgical management were described by reviewing the patient's electronic medical records. This case reports on a 37-year-old male patient who suffered penetrating trauma to the skull from the brake lever of his bicycle as a result of an accidental fall while cycling. Brought in by the SAMU, the patient had a Glasgow score of 15, a preserved left orbit, while the right orbit showed no eye opening, amaurosis, a non-photo-reagent mydriatic pupil, both to the direct and indirect reflex. A computed tomography scan of the skull showed a metal brake handle lodged in the skull on the right, causing a fracture of the orbital face of the zygomatic and greater wing of the sphenoid, with the end in the orbit. In the operating room, the object was carefully extracted without complications. On the first postoperative day, a magnetic resonance imaging scan was requested, which revealed a hemorrhagic contusion of the temporal lobe on the right side, rupture of the lateral rectus muscle, hematic and gaseous contents inside the orbit, as well as a possible retinal detachment. On the sixth post-operative day, with amaurosis maintained on the right, the patient was discharged and referred for specialized ophthalmological follow-up. Penetrating cranio-orbital trauma has potentially fatal outcomes if not diagnosed and managed early and properly.http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0034-72802024000100520&lng=en&tlng=enHead injuries, penetratingOrbitBlindnessRetinal detachmentOrbital fracturesCyclistBicyclingMagnetic resonance imaging
spellingShingle Paulo Henrique Alves Togni Filho
Roscicler Pereira de Sousa
André Luís Santos Vaz Leite
Bruno Previdelli Coghi
Guilherme Augusto Paro
Guilherme Amantéa Costa Carvalho
Transorbitary intracranial penetrating injury involving bicycle brake handle: case report and literature review
Revista Brasileira de Oftalmologia
Head injuries, penetrating
Orbit
Blindness
Retinal detachment
Orbital fractures
Cyclist
Bicycling
Magnetic resonance imaging
title Transorbitary intracranial penetrating injury involving bicycle brake handle: case report and literature review
title_full Transorbitary intracranial penetrating injury involving bicycle brake handle: case report and literature review
title_fullStr Transorbitary intracranial penetrating injury involving bicycle brake handle: case report and literature review
title_full_unstemmed Transorbitary intracranial penetrating injury involving bicycle brake handle: case report and literature review
title_short Transorbitary intracranial penetrating injury involving bicycle brake handle: case report and literature review
title_sort transorbitary intracranial penetrating injury involving bicycle brake handle case report and literature review
topic Head injuries, penetrating
Orbit
Blindness
Retinal detachment
Orbital fractures
Cyclist
Bicycling
Magnetic resonance imaging
url http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0034-72802024000100520&lng=en&tlng=en
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