An occult intracranial foreign body introduced via a conjunctival wound. (July 2013)

• Record Type: Journal Article
• Authors: Vaqas, Babar; Kopniczky, Zsolt; Haliasos, Nik; Namnyak, Simon; Pollock, Jonathan
• Is Part Of: Trauma. Volume 15:Number 3(2013)
• Page Start: 252
• Page End: 256
• Publication Date: 2013-07
• Subjects: Intracranial foreign body -- orbital injury -- conjunctival injury -- penetrating brain injury -- head trauma -- craniotomy; Traumatology -- Periodicals; Disaster medicine -- Periodicals; Wounds and injuries -- Periodicals; Electronic journals; 617.1
• DOI: 10.1177/1460408613497145
• Languages: English
• ISSNs: 1460-4086

Abstract

We present a case of a 23-year-old man who suffered a facial assault. An intracranial foreign body, a socket from a socket wrench, was introduced into the cranial cavity via a medial conjunctival entry wound which presented with minimal physical signs. The entry wound and the foreign body were missed during the patient's first presentation to an emergency department leading to a delay in diagnosis. Subsequent periorbital swelling and visual blurring prompted delayed investigation leading to detection of the foreign body. This case report highlights the need for a high index of suspicion of intracranial complications when assessing ocular injuries. The mechanism of the penetrating injury, the ophthalmological findings and the surgical and antibiotic management are discussed.