Lesión intracraneal transorbitaria por florete. Caso clínico / Cranial wounds of the skull by fencing - foil

Introducción. Las heridas penetrantes intracraneales por arma blanca son poco frecuentes en países occidentales y su diagnóstico y tratamiento pueden presentar dificultades que las hacen diferentes al resto de los traumatismos de cráneo. Caso clínico. Se presenta el caso de un profesor de esgrima que practicando sin la debida protección, recibió una lesión por florete, transorbitaria derecha con penetración intracraneana. La misma le produjo un hematoma intraparenquimatoso temporoparietal derecho, con efecto de masa. Dicha lesión se hizo evidente en la evolución, ya que de inicio, el paciente no presentó ningún síntoma oftalmológico o neurológico. El hematoma se evacuó sin incidentes con buena evolución clí- nica del paciente. No hubo lesiones en el globo ocular. Discusión y conclusiones. La lesión de estructuras intracraneales por objetos penetrantes transorbitarios es poco frecuente. Su diagnóstico exige un alto índice de sospecha, teniendo en cuenta el objeto agresor, mas allá del estado clínico inicial del paciente (AU)

Penetrating stab cranial wounds of the skull by fencing - foil are rare in western countries. Case report. This 46 year old man suffered a penetrating stab wound of the skull throughout the right orbital region. As a consecuence he developed on intracranial hematoma requiring surgical evacuation. Discussion and conclusions. Damage of intracranial cuntents due to transorbital penetrating objects other than missiles is a rare event (AU)

[Penetrating transorbital intracranial foreign body].

About a month prior to admission to our hospital, a 25-year-old man had a quarrel with his friend and was stabbed in his left eye with a cracked bottle of beer. He underwent emergency operation for the injured left eye. Subsequently he was admitted to an ophthalmological ward in our hospital for plastic surgery of an artificial eye. An intracranial foreign body was pointed out, and he was soon transferred to our neurosurgical ward. Plain x-ray films and tomograms of the skull and CT scan showed a foreign body at medial portion of the left superior orbital fissure. Carotid angiography revealed no significant implication of the cerebral vessels. As there was a strong suspicion of cerebral contusion or liquorrhea, a pterional craniotomy was so designed as to do removal of thie foreign body and repair of the dura mater in one stage. The post-operative couse was uneventful without liquorrhea or miningitis. It was emphasized that pterional approach used by Hamby (1970) for surgery of malignant exophthalmos was useful and felicitious in this case. It was additionally reported that cerebrospinal orbitorrhea observed in this case was rare and it might be the third case in the literature.