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Orbitocranial penetration by a fern: case report
R J Kahler1, F H Tomlinson, D P Eisen
1Department of Neurosurgery, Royal Children's Hospital, Brisbane, Australia.
Neurosurgery
|June 19, 1998
Summary
Organic foreign material penetrating the skull requires prompt identification and removal. Magnetic resonance imaging is crucial for diagnosis, though it may not detect all organic foreign bodies.
Area of Science:
- Neurosurgery
- Radiology
- Ophthalmology
Background:
- Organic foreign body penetration into cranial and orbitocranial structures is a recognized clinical challenge.
- Timely diagnosis and complete removal of these foreign materials are essential for patient outcomes.
Observation:
- A case of a 15-month-old child with orbitocranial penetration by a fern stem is presented.
- The foreign body traversed the orbit, superior orbital fissure, middle cranial fossa, and lodged in the posterior cranial fossa.
Findings:
- Surgical intervention using a modified Dolenc procedure successfully removed the fern stem.
- The foreign body was located in the prepontine cistern, with remaining fragments removed via extradural approaches to the cavernous sinus and superior orbital fissure.
Implications:
- Complete removal of retained intracranial organic foreign material is critical.
- Magnetic resonance imaging (MRI) is the preferred diagnostic modality, but its limitations in detecting certain organic materials must be considered.