scholarly journals Management of constant proptosis after traumatic orbital roof fracture caused by firearm projectile

2021 ◽  
Vol 9 (12) ◽  
Author(s):  
Craig Czyz ◽  
Tyler Greenlee ◽  
Reece Bergstrom
Keyword(s):  
Cerebrospinal Fluid ◽  
Compartment Syndrome ◽  
Brain Tissue ◽  
Treatment Options ◽  
Cerebrospinal Fluid Leak ◽  
Gunshot Wounds ◽  
High Energy ◽  
Ocular Tissues ◽  
Orbital Roof ◽  
Fluid Leak

Orbital injuries causing severe proptosis are most often caused by high-energy, blunt force trauma, but can also be associated with penetrating traumas, such as firearm projectiles. Head trauma resulting in orbital roof fracture and significant communication between the anterior cranial fossa and posterior orbit are rare events, with herniation of brain tissue and cerebrospinal fluid into the orbit even more uncommon and found in only a small percentage of cases. When present, the herniating tissue and/or fluid can cause significant proptosis and potentially orbital compartment syndrome that increases the risk of damage to the optic nerve and its surrounding structures. Often this condition is managed surgically in an urgent manner to preserve visual acuity and the ocular tissues. In cases of constant proptosis in the setting of orbitocranial injuries, practitioners should balance the risks and benefits of intervention ensuring the best possible clinical outcomes. It is imperative to remember that the proptosis is a clinical finding that is itself not pathognomonic for any particular disease entity. The following case describes a 20-year old male that presented with multiple gunshot wounds, one of which caused a penetrating injury to the orbit and subsequent brain tissue herniation and cerebrospinal fluid leak with associated constant proptosis and orbital compartment syndrome. This case report examines the treatment options in severe cases of traumatic, constant proptosis, with or without orbital compartment syndrome, and the methods used to preserve vision, anatomy, and prevent severe complications.

scholarly journals Management of cerebrospinal fluid leak from cervical gunshot wounds with external ventricular drainage: a small case series

2020 ◽  
Vol 2020 (12) ◽  
Author(s):  
Clifford L Crutcher ◽  
John M Wilson ◽  
Kevin D Morrow ◽  
Jessica A Shields ◽  
Lindsay M Lasseigne ◽  
...  
Keyword(s):  
Cerebrospinal Fluid ◽  
External Ventricular Drain ◽  
Treatment Algorithm ◽  
Case Series ◽  
Cerebrospinal Fluid Leak ◽  
Gunshot Wounds ◽  
External Ventricular Drainage ◽  
Csf Leak ◽  
Fluid Leak ◽  
Csf Leaks

Abstract Historically, the surgical management of gunshot wounds to the spine has been controversial. Repair of a persistent cerebrospinal fluid (CSF) leak is a generally agreed upon indication. The management of such CSF leaks typically involves lumbar drainage or direct surgical repair. Here, the authors report two cases of CSF diversion with an external ventricular drain (EVD) in patients with cervical gunshot wounds. Both patients had spinal canal obliteration or physiologic myelographic block at or below the level of injury. To the best of the author’s knowledge, these are the first two reports of successful EVD treatment of persistent CSF leaks related cervical gunshot wounds. The authors also propose a CSF treatment algorithm for cervical gunshot wounds that includes EVD.

scholarly journals Safety and effectiveness of microvascular decompression for treatment of hemifacial spasm through mini craniotomy

2017 ◽  
Vol 31 (4) ◽  
pp. 495-509
Author(s):  
Ashraf ElBadry ◽  
Nabil Mansour ◽  
Ahmed Abdelkhalek
Keyword(s):  
Cerebrospinal Fluid ◽  
Hemifacial Spasm ◽  
Microvascular Decompression ◽  
Treatment Options ◽  
Cerebrospinal Fluid Leak ◽  
University Hospital ◽  
Factors Affecting ◽  
The Face ◽  
Vascular Element ◽  
Fluid Leak

Abstract Background: The hemifacial spasm (HFS) defined as involuntary intermittent twitching of the muscles of the face (usually unilateral). The spasms characteristically begin around the eye and then extend to affect other muscles of the ipsilateral face. It is caused by vascular element compressing the facial nerve that may be either the anterior or the posterior inferior cerebellar arteries in most cases. Objective of our work: to describe the operative technique (pearls and common mistakes), the efficacy and morbidity of microvascular decompression technique for hemifacial spasm through mini craniotomy, determine the prognostic factors affecting success rate of the surgery. Material & method: A retrospective study of 23 cases of hemifacial spasm treated by mini craniotomy retro sigmoid approach and microvascular decompression at neurosurgery dept., Mansoura University Hospital in last 10 years was investigated. This include Epidemiological, clinical and imaging details, selected treatment options and patients’ outcome. Results: complete resolving of symptoms was conducted in 19 cases 82.6% while reoperated in 2 cases with improvement in one case. Facial palsy appeared postoperative in 6 cases 4 of them improved in 3 months, transient hearing loss in 4 cases17.4% which improved later, cerebrospinal fluid leak appeared in 3 cases 13% which managed conservatively. Conclusions: MVD relieves symptoms of HFS in about 80% of patients while recurrence still in low percentage. The study reported low permanent Complications and generally transient.

Endoscopic Management of the Cerebrospinal Fluid Leak

Skull Base ◽  
2009 ◽  
Vol 19 (S 02) ◽  
Author(s):  
E. Pasquini ◽  
G. Tenti ◽  
C. Bordonaro ◽  
P. Farneti ◽  
V. Sciarretta ◽  
...  
Keyword(s):  
Cerebrospinal Fluid ◽  
Cerebrospinal Fluid Leak ◽  
Endoscopic Management ◽  
Fluid Leak

scholarly journals Crayon in the Orbit and Sinuses in a Pediatric Patient

2021 ◽  
pp. 014556132110185
Author(s):  
Michela Borrelli ◽  
Kristen A. Echanique ◽  
Jeffrey Koempel ◽  
Elisabeth H. Ference
Keyword(s):  
Cerebrospinal Fluid ◽  
Skull Base ◽  
Pediatric Patient ◽  
Cerebrospinal Fluid Leak ◽  
Ethmoid Sinus ◽  
Rare Occurrence ◽  
Lamina Papyracea ◽  
The Right ◽  
Fluid Leak ◽  
Type Of Injury

Penetrating transorbital injury with skull base involvement is a rare occurrence from a crayon. We report a case of a 2-year-old male who sustained a penetrating crayon injury through the right orbit and lamina papyracea into the posterior ethmoid sinus complicated by cerebrospinal fluid leak. There have been no other reported cases of this type of injury by a crayon.

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