Presentation
This patient was gardening and bent over to weed, and felt a stabbing pain in the region of his eye. He stood up and extracted a piece of wood from just above his eye. He felt fine but went to see his local doctor, who examined him, and only saw a small puncture wound. Eye motion was normal. The next day the patient developed right sided weakness and presented to hospital.
Patient Data
Transorbital penetrating brain injury.
Transorbital penetrating brain injury. Note how well SWI imaging demonstrates the tract.
Case Discussion
The wooden stake had passed above and medial to the globe, though the apex of the orbit associated with a fracture of the lesser wing on sphenoid. It then passed all the way to the parieto-occipital region, abutting the inner aspect of the skull.