Transorbital Penetrating Intracranial Injury with an Umbrella Wire Causing Cavernous Internal Carotid Artery Injury and Thrombosis.

Abstract

Transorbital penetrating intracranial injuries, though rare, can have serious consequences. Intracranial penetration can be present even if orbital trauma is trivial. We report an unusual case of transorbital penetrating intracranial injury with umbrella wire, sustained while opening an umbrella, leading to internal carotid artery injury and thrombosis. The patient sustained only ipsilateral third nerve palsy that completely recovered during followup. Trivial orbital injuries can be associated with significant intracranial injury in a neurologically intact patient. This case emphasizes the potentially injury-prone opening mechanism of conventional umbrellas. A high index of suspicion is important while evaluating such patients.