A 40-year-old man presented with concern for open globe injury in the right eye after his nail gun malfunctioned. He was found to have an 8.2-cm nail traversing the lateral orbit and penetrating the right frontal lobe. He was urgently evaluated by neurosurgery and subsequently underwent removal of the nail by a team including neurosurgery, oculoplastic surgery, and ocular trauma. Upon exploration of the globe, the patient was found to have a partial thickness scleral laceration with an injury to the lateral rectus muscle, which were repaired. Post-operatively, he was found to have a dilated examination concerning for sclopetaria, chorioretinal rupture. He later developed a retinal detachment and required several retinal surgeries due to recurrent retinal detachment before achieving a stable eye exam.
Intracranial injury Intracranial foreign body Orbital foreign body Open globe exploration Neurosurgery consult
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Schreckinger M, et al. Transorbital penetrating injury: case series, review of the literature, and proposed management algorithm. J Neurosurg. 2011;114(1):53–61.CrossRefPubMedGoogle Scholar
Strub WM, Weiss KL. Self-inflicted transorbital and intracranial injury from eyeglasses. Emerg Radiol. 2003;10(2):109–11.CrossRefPubMedGoogle Scholar
Riley JP, et al. The role of intraoperative cerebral angiography in transorbital intracranial penetrating trauma: a case report and literature review. World Neurosurg. 2017;97:761 e5–761 e10.CrossRefGoogle Scholar
Lunetta P, Ohberg A, Sajantila A. Suicide by intracerebellar ballpoint pen. Am J Forens Med Pathol. 2002;23(4):334–7.CrossRefGoogle Scholar