[Orbital screwdriver injury in a toddler]

Area of Science:

• Neurosurgery
• Ophthalmology
• Trauma Surgery

Background:

• Orbital intracranial penetrating injuries are uncommon and pose significant management challenges.
• Prompt diagnosis and surgical intervention are crucial for favorable outcomes.

Observation:

• A patient sustained a penetrating orbital intracranial injury from a screwdriver.
• The screwdriver traversed the medial orbital wall, passed extracranially medial to the internal carotid artery, and entered the intracranial cavity, reaching the sella turcica and dorsum sellae.

Findings:

• Imaging confirmed the screwdriver's trajectory without evidence of intracranial hemorrhage.
• Surgical removal of the foreign body was achieved without any intraoperative or postoperative complications.
• Minimal bleeding was noted during the procedure.

Implications:

• This case highlights the importance of meticulous surgical technique in managing complex orbital foreign body retrievals.
• Successful outcomes are achievable even with extensive intracranial trajectories, emphasizing the role of advanced imaging and neurosurgical expertise.
• The case underscores the need for neurosurgical and ophthalmological collaboration in managing such severe penetrating injuries.