Delayed presentation of transorbital intracranial pen

A 13 year old Fijian boy sustained a stab wound to the left orbit 3 years a go. It was not appreciated by the treating physicians in Fiji that the plas tic pen had crossed from the left orbit, through the nose, right orbit and right optic nerve, into the right middle cranial fossa and lodged in the ri ght temporal lobe and that the pen remained in situ for the past 3 years. T he boy presented to Australia with a discharge from the entry wound in his left lower eyelid. The retained foreign body was not detected on computed t omography imaging, but was detected on subsequent magnetic resonance image. A combined neurosurgery/plastic surgery craniofacial approach was undertak en with successful complete removal of the retained pen, and preservation o f Vision in his only seeing eye. (C) 2000 Harcourt Publishers Ltd.