The use of CT angiography for preoperative evaluation of large foreign body retention following penetrating trauma

Introduction. A transorbital intracranial injury with a foreign body can be a very complex and controversial therapeutic problem. The orbit's content is susceptible to penetrating trauma, and neurovascular skull base structures are at high risk from injury. There are some traditional cranial surgical approaches, and more recently reported different endoscopic approaches for treating this kind of injury. Case report. We present a case of a 30-year-old male who had an accident at work when a piece of wood hit him in his head and entered through the medial aspect of his left orbit with skull base and cavernous sinus injury. Rapid and complete radiological and clinical assessments were performed, and the patient was treated in a minimally invasive manner. The foreign body was manually extracted with an endoscopic and endovascular team ready to treat adverse events. No postoperative complications were reported, and visual acuity increased at one month follow up. Conclusion. Penetrating wounds of the orbit represent a challenge that requires a multidisciplinary assessment and well-organized management. Combined endoscopic minimally invasive approaches should be considered during the treatment of this kind of injury.

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Preoperative Evaluation of Intracranial Aneurysms: Usefulness of Intraarterial 3D CT Angiography and Conventional Angiography with a Combined Unit—Initial Experience

Radiology ◽

10.1148/radiology.220.2.r01au20499 ◽

2001 ◽

Vol 220 (2) ◽

pp. 499-505 ◽

Cited By ~ 29

Author(s):

Toshinori Hirai ◽

Yukunori Korogi ◽

Ken Ono ◽

Yuka Murata ◽

Kenji Suginohara ◽

...

Keyword(s):

Ct Angiography ◽

Intracranial Aneurysms ◽

Preoperative Evaluation ◽

Initial Experience ◽

3D Ct ◽

Conventional Angiography ◽

3D Ct Angiography

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Extremity Trauma: Foreign Bodies and Vascular Injury

10.2310/em.4710 ◽

2015 ◽

Author(s):

David A. Meguerdichian ◽

John Eicken

Keyword(s):

Foreign Body ◽

Vascular Injury ◽

Foreign Bodies ◽

Significant Proportion ◽

Ankle Brachial Index ◽

Penetrating Trauma ◽

Trauma Patients ◽

Peripheral Vasculature ◽

Extremity Trauma ◽

Upper And Lower Extremities

It is important for physicians to be mindful of the possibility of a foreign body in the context of extremity trauma. Patients with foreign bodies may not suspect their presence, and a significant proportion of foreign bodies are missed by the initial treating physician. Trauma injuries to the peripheral vasculature can be divided into blunt and penetrating trauma, and can also be classified as occlusive or nonocclusive injuries. This review details the assessment and stabilization, diagnosis, treatment and disposition, and outcomes for patients with foreign body and vascular injuries. Figures show beside ultrasonography using a linear ray probe that demonstrates a foreign body wood splinter in soft tissue, the major arteries of the upper and lower extremities, and measurement of the ankle-brachial index in an injured limb with suspected vascular injury. Tables list supplies needed to perform bedside ultrasound-guided foreign body removal, steps to remove a foreign body under ultrasound guidance, hard and soft signs of arterial injuries, and high-risk orthopedic injuries and their commonly associated vascular injury. This review contains 4 figures, 4 tables, and 51 references.

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Pancreatic Adenocarcinoma: Value of Multidetector CT Angiography in Preoperative Evaluation

Radiology ◽

10.1148/radiol.2453061795 ◽

2007 ◽

Vol 245 (3) ◽

pp. 770-778 ◽

Cited By ~ 87

Author(s):

Giulia A. Zamboni ◽

Jonathan B. Kruskal ◽

Charles M. Vollmer ◽

Jovanna Baptista ◽

Mark P. Callery ◽

...

Keyword(s):

Pancreatic Adenocarcinoma ◽

Ct Angiography ◽

Multidetector Ct ◽

Preoperative Evaluation ◽

Multidetector Ct Angiography

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Six-year epidemiological analysis of post traumatic endophthalmitis in a Brazilian hospital

International Journal of Retina and Vitreous ◽

10.1186/s40942-019-0193-8 ◽

2019 ◽

Vol 5 (1) ◽

Cited By ~ 1

Author(s):

Luis Filipe Nakayama ◽

Vinicius Campos Bergamo ◽

Nilva Simeren Bueno de Moraes

Keyword(s):

Visual Acuity ◽

Foreign Body ◽

Penetrating Trauma ◽

Onset Time ◽

Intraocular Foreign Body ◽

Time Interval ◽

Light Perception ◽

Initial Visual Acuity ◽

Open Globe ◽

Better Than

Abstract Background To evaluate the epidemiology of endophthalmitis cases related to ocular trauma, including visual acuity during and 1 year after trauma, source of trauma and method of treatment. Methods A retrospective study analyzed the epidemiological data of patients with a clinical presentation of endophthalmitis after ocular penetrating trauma between January 2012 and January 2017 at Escola Paulista de Medicina/UNIFESP, a hospital in São Paulo, SP, Brazil. Results A total of 453 patients with antecedent open globe trauma were evaluated, among these, 30 patients with suspected endophthalmitis. All patients were male. The time interval between trauma and ophthalmological evaluation and collection of vitreous and aqueous material was 1 day in 36.66%, 2–7 days in 43.44%, 7–14 days in 10% and more than 15 days in 10% of patients; 66.66% had positive cultures. 11 patients had intraocular foreign body. One year after trauma, visual acuity was classified as no light perception (NLP) in 33.33%, light perception in 6.66%, hand motion in 13.33%, counting fingers in 13.33%, and better than 20/400 in 20% of patients. Considering presence of intraocular foreign body, initial visual acuity and symptoms onset time, only initial visual acuity showed as better prognostic factor in final visual acuity. Conclusion Endophthalmitis is a severe ocular inflammatory condition that may lead to irreversible vision loss. Initially only one patient had visual acuity of NLP, but after 1 year, 33% showed visual acuity of NLP, and only 20% had visual acuity better than 20/400, what is consistent with a severe infection with a guarded prognosis. The high incidence of endophthalmitis after ocular penetrant trauma justifies distinct treatment and greater attention.

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