Orbital foreign body

Case contributed by Dr Laughlin Dawes

Presentation

"This may sting a little..."

Patient Data

Age: Adult
Gender: Male

CT brain

Modality: CT

Single image from an axial CT scan demonstrates a mostly gas density object with a metal tip projecting through the orbit, medial to the globe, through the lateral orbital wall just lateral to the superior orbital fissure and into the temporal lobe. No large haemorrhage is present. A small amount of gas is seen at the fracture site. 

Case Discussion

This patient presented with a self-harm injury. 

The pen missed optic nerve, middle cerebral artery and any eloquent brain. A cerebral angiogram was performed which was normal except for truncation of the ophthalmic artery (not shown). The pen was removed under flouroscopic guidance. Upon removal, there was brisk bleeding from the ophthalmic artery. Endovascular embolisation of the bleeding vessel was performed with coils, with good result. The patient’s pupil remains reactive, suggesting a good prognosis for the optic nerve and the patient’s vision. 

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Case Information

rID: 3270
Case created: 22nd May 2008
Last edited: 31st Oct 2015
Inclusion in quiz mode: Included

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