Meat Hook Injury Leading to Brain Abscess: A Rare Occurrence

IF 0.2 Q4 NEUROSCIENCES Indian Journal of Neurotrauma Pub Date : 2021-07-29 DOI:10.1055/s-0041-1732789
Batuk D. Diyora, G. Dhall, Mehool Patel, Mazhar Mulla, Nilesh More, A. Shah
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Abstract

Abstract Transorbital orbitofrontal penetrating injury by a nonmissile object is uncommon. The presentation of this injury varies. This injury can be easily missed during the initial clinical presentation, because the foreign body is sometimes not visible on local examination, the wound on the orbital skin is small, and very subtle signs are present. The patient can present with delayed complications of the primary injury. Our patient was a 33-year-old male who presented with an orbitofrontal injury with a meat hook. He had minor symptoms at the time of presentation, which were overlooked. Three weeks later, he developed signs and symptoms of raised intracranial pressure (ICP). Brain imaging revealed a peripheral rim of contrast-enhancing mass lesion in the right frontal lobe, extending into the right orbit with perilesional edema suggestive of posttraumatic brain abscess. Via right frontal craniotomy, pus was drained out and abscess wall was excised. The patient made good clinical recovery. A higher index of suspicion and sound knowledge of occult penetrating injury patterns is required in the cases of orbital injuries. Appropriate radiological imaging can lead to an earlier and accurate diagnosis, and can prevent its delayed sequela like brain abscess.
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肉钩伤导致脑脓肿:罕见的发生
摘要非飞弹物体造成的跨眶眶额穿透伤并不常见。这种损伤的表现各不相同。这种损伤在最初的临床表现中很容易被遗漏,因为异物有时在局部检查中是看不见的,眼眶皮肤上的伤口很小,并且存在非常微妙的体征。患者可出现原发性损伤的延迟并发症。我们的病人是一名33岁的男性他的眼窝额部因肉钩受伤。他在就诊时有轻微症状,但被忽视了。三周后,患者出现颅内压升高的体征和症状。脑成像显示右额叶周围边缘有增强对比的肿块病变,延伸至右眼眶,病灶周围水肿提示创伤后脑脓肿。经右额叶开颅,排出脓液,切除脓肿壁。病人临床恢复良好。在眼眶损伤的情况下,需要更高的怀疑指数和对隐蔽性穿透性损伤模式的充分了解。适当的影像学检查可早期准确诊断,并可预防其迟发性后遗症,如脑脓肿。
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