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首页> 外文期刊>Journal of neurosurgical sciences >Surgical treatment of penetrating orbito-cranial injuries. Case report.
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Surgical treatment of penetrating orbito-cranial injuries. Case report.

机译：穿透性颅颅损伤的外科治疗。案例报告。

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Penetrating orbital injuries are not frequent but neither are they rare. The various diagnostic and therapeutic problems are related to the nature of the penetrating object, its velocity, shape and size as well as the possibility that it may be partially or wholly retained within the orbit. The authors present another case with unusual characteristics and discuss the strategies available for the best possible treatment of this traumatic pathology in the light of the published data. The patient in this case was a young man involved in a road accident who presented orbito-cerebral penetration caused by a metal rod with a protective plastic cap. Following the accident, the plastic cap (2.5x2 cm) was partially retained in the orbit. At initial clinical examination, damage appeared to be exclusively ophthalmological. Subsequent CT scan demonstrated the degree of intracerebral involvement. The damaged cerebral tissue was removed together with bone fragments via a bifrontal craniotomy, the foreign body was extracted and the dura repaired. Postoperative recovery was normal and there were no neuro-ophthalmological deficits at long-term clinical assessment. Orbito-cranial penetration, which is generally associated with violent injuries caused by high-velocity missiles, may not be suspected in traumas produced by low-velocity objects. Diagnostic orientation largely depends on precise knowledge of the traumatic event and the object responsible. When penetration is suspected and/or the object responsible is inadequately identified, a CT scan is indicated. The type of procedure to adopt for extraction, depends on the size and nature of the retained object. Although the possibility of non-surgical extraction has been described, surgical removal is the safest form of treatment in cases with extensive laceration and brain contusion.
机译：眼眶穿透伤并不常见，但也不罕见。各种诊断和治疗问题与穿透物体的性质，其速度，形状和大小以及其可能部分或全部保留在轨道内的可能性有关。作者提出了另一例具有不同寻常特征的案例，并根据已发表的数据讨论了可最佳治疗这种创伤性病理的策略。该例患者是一名年轻男子，他是一名道路交通事故的肇事者，他因带保护性塑料帽的金属棒引起的眶脑穿透。事故发生后，塑料盖（2.5x2厘米）被部分保留在轨道中。在最初的临床检查中，损害似乎完全是眼科的。随后的CT扫描显示脑内受累程度。通过双额开颅手术将受损的脑组织与骨碎片一起去除，取出异物并修复硬脑膜。长期临床评估后，术后恢复正常，无神经眼科缺陷。在低速物体造成的创伤中，可能不会怀疑眶颅穿透力，通常与高速导弹造成的暴力伤害有关。诊断的方向很大程度上取决于对创伤事件和责任对象的确切了解。当怀疑渗透和/或不能充分识别负责的物体时，将显示CT扫描。提取所采用的程序类型取决于保留对象的大小和性质。尽管已经描述了非手术拔除的可能性，但是对于有广泛裂伤和脑挫裂伤的病例，手术切除是最安全的治疗方法。

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