[A toddler with a haematoma of an eye after a fall]

Area of Science:

• Pediatric neurosurgery
• Neuroradiology
• Traumatic brain injury

Background:

• Pencil injuries are uncommon but can cause significant intracranial damage.
• Early diagnosis is crucial for effective management of pediatric head trauma.

Observation:

• A 2-year-old boy presented after a fall at home.
• Physical examination revealed minor external ocular findings (blood in the inner canthus of the right eye).

Findings:

• Magnetic Resonance Imaging (MRI) demonstrated a clear pencil tract.
• The tract extended from the initial point of impact into the frontal lobes of the brain.

Implications:

• This case highlights the importance of advanced imaging in suspected intracranial foreign body injuries.
• Prompt diagnosis and surgical intervention are critical for managing such pediatric neurotrauma.
• Such injuries necessitate a high index of suspicion despite seemingly minor external signs.