'Splinter in the mind': a case of penetrating periorbital injury

A case of penetrating orbitocranial injury in a 12-year-old boy is described. The orbital injuries are usually obvious on presentation and receive prompt attention but a high index of suspicion is needed together with specialized imaging to diagnose the frequently coexistent intracranial penetration. Intracranial suppuration is the major complication with combined mortality from all complications reported to be as high as 25%. The value of aggressive antibiotic therapy and formal exploration is emphasized and the importance of wood as a particularly hazardous foreign body is stressed.