Household Objects as a Cause of Self-inflicted Orbital Apex Syndrome

Abstract

This report describes two cases of self-inflicted penetrating nonprojectile orbitointracranial injury. Suicide attempts caused by these types of injuries are very rare. An understanding of the orbital and intracranial anatomy and the avoidance head turn help to predict potential injury sites. Computed tomography and cerebral angiography were helpful in the treatment of these two cases.

Self-inflicted eye injuries: a review

“…3,[48][49][50] However, they are of great importance, as failure to recognise the injury may be fatal. A penetrating object of greater than 5 cm in length may reach the cranial cavity via the superior orbital fissure, shearing vessels, and nerves as it travels.…”

“…51 Pens 3,49,51 and pencils 50 are the commonest reported objects causing self-inflicted orbital injuries, while there has been one report of using a toothbrush. 48 Frequently, the eye is spared significant injury due to scleral resistance. 51 Rarely, firearms may be the mode of the self-inflicted injury, often resulting in severe injury of both ocular and orbital tissues.…”

Intraorbital Foreign Body With Intracranial Extension: A Case Series

“…2,3 If it gains access through superior orbital fissure, it is directed towards cavernous sinus, which is reflected in our study as well. 4 Signs and symptoms depends upon the nature of foreign body, extent of penetration and injury to the neurovascular structures.…”

Orbitocranial penetrating injury by a metallic foreign body. Case report and anatomical considerations

“…According to some authors, the great incidence of those OPI with roof fractures is due to the instinctive tendency of humans to extend the neck backwards in a defensive position at the moment of orbital trauma (28,32). Because at the time of trauma humans avoid turning their heads, this may guide horizontally approaching objects into the medial canthus region and along the medial orbital wall (22). In our patient's case, the foreign body penetrated the orbit at the medial canthus and followed a posterior, medial and superior trajectory through the orbital roof (Figure 3.…”