Abstract
Orbital penetrating injuries are uncommon and occur following accidental entry of
objects through orbit. The authors report an interesting case of right frontal abscess
resulting from orbitocranial penetrating injury due to accidental penetration of wooden
stick into the right eye, which remained undiagnosed. A 70-year-man presented with
complaints of headache and vomiting for few days. His computed tomographic (CT) scan
of the brain revealed peripheral rim-enhancing cystic lesion in the right frontal
lobe with perilesional edema, mass effect, and midline shift. Orbital CT scan revealed
hyperdense lesion just lateral to medial orbital wall. Magnetic resonance imaging
of the brain showed cystic peripheral rim-enhancing lesion that was homogenous hypointense
on T1-weighted images and homogenous hyperintense on T2-weighted images. The patient
underwent right frontal craniotomy. Pus was drained out, and abscess wall was excised.
Foreign bodies protruding through fractured orbital roof were found and removed. He
made good clinical recovery. He has received intravenous antibiotics for 2 weeks followed
by 4 weeks of oral antibiotics. He had no visual symptoms. The authors report the
case, review the literature, and highlight need for imaging in every case of orbital
penetrating injury to prevent the life-threatening cerebral parenchymal complications.
Keywords
orbital injury - cranial injury - penetrating injury - abscess
