Transorbital intracranial penetrating injury-an anatomical classification

Chandramouli Balasubramanian, Chandrasekaran Kaliaperumal, Changez K Jadun, Palitha S Dias

Research output: Contribution to journalArticlepeer-review


BACKGROUND: A transorbital intracranial injury with a wooden foreign body can be very difficult to diagnose and manage. The orbit forms an easy path for low-velocity foreign bodies into the intracranial space. The severity of the injury is often masked by unobtrusive superficial wounds. Computed tomography (CT) findings may be misinterpreted as pneumocephalus.

CASE DESCRIPTION: We present a young gentleman who had a fall under the influence of alcohol near a bush and, on clinical presentation, had very little signs of a penetrating injury in the skin. There was some numbness in the V1 distribution of the trigeminal nerve. Further investigation and management are described.

CONCLUSION: Although magnetic resonance imaging is more sensitive and specific, a CT angiogram with 3-dimensional reconstruction will provide much insight into the mode of intervention required. We present an anatomical classification for such injuries.

Original languageEnglish
Pages (from-to)238-40
Number of pages3
JournalSurgical Neurology
Issue number2
Publication statusPublished - Feb 2009


  • Adult
  • Foreign Bodies
  • Head Injuries, Penetrating
  • Humans
  • Imaging, Three-Dimensional
  • Magnetic Resonance Imaging
  • Male
  • Orbit
  • Tomography, X-Ray Computed

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