Management of Transorbital Penetrating Intracranial Injury by a Homemade Metal Arrow: Serials Case Report


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Title Management of Transorbital Penetrating Intracranial Injury by a Homemade Metal Arrow: Serials Case Report
Creator Prasetyo, Eko
Oley, Maximillian Christian
Islam, Andi Asadul
Prihantono, Prihantono
Subject homemade metal arrow
transorbital penetrating intracranial injury
traumatic brain injury
Description BACKGROUND: Transorbital penetrating intracranial injury (TOPI) is rare lesions, representing about 0.4% of traumatic brain injury. This uncommon injury has potentially severe and fatalities brain damage with high mortality rate if not promptly treated.
CASE REPORT: We presented three patients with TOPI following penetration by a homemade metal arrow; unfortunately, two patients (cases 1 and 2) death on arrival at our hospital. As a survival patient (case 3), a 15-year-old boy presented with a homemade metal arrow entered through a right superior orbital fissure into the right cerebral hemisphere. Plain skull radiograph showed that the tip of the shaft was located in the right of the posterior cerebral hemisphere and confirmed by computerized tomography (CT) and three-dimensional CT of his brain. Injury to the right middle cerebral arteries was apparent on non-contrast CT angiography. Using a right occipital craniotomy approach with C-arm radiography fluoroscopy guidance, we successfully removed the arrow. Follow-up studies confirmed an excellent outcome.
CONCLUSIONS: Pre-operative imaging is mandatory to evaluate the trajectory, brain, and vascular injury for appropriate surgical planning and post-operative care of patients with TOPI.
Publisher Scientific Foundation SPIROSKI, Skopje, Republic of Macedonia
Date 2020-02-05
Type info:eu-repo/semantics/article
Format application/pdf
Source Open Access Macedonian Journal of Medical Sciences; Vol. 8 No. C (2020): C- Case Reports; 30-35
Language eng
Rights Copyright (c) 2020 Eko Prasetyo, Maximillian Christian Oley, Andi Asadul Islam, Prihantono Prihantono (Author)

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