ORBITO-CRANIAL INJURY CAUSED BY PENETRATING METALLIC FOREIGN-BODIES -REPORT OF 2 CASES

Two cases of orbito-cranial injury caused by foreign bodies (FBs) pene trating the lateral wall and roof of the orbit are described. In the f irst patient, a long rusted nail acted as a missile and was only detec ted by X-rays and CT scan. The nail penetrated the orbit, the eyeball, the lateral orbital wall, and the temporal lobe of the brain. Lodged partly in the orbit and partly in the brain, this nail caused leakage of cerebrospinal fluid (CSF) through eye and led to orbital cellulitis and localized meningitis. The foreign body (FB) was removed through a n extradural pterional approach with rapid resolution of orbital cellu litis and meningitis. In the second patient, large metallic FB, having penetrated the orbital roof was lodged intracranially above: the chia sma. This was removed via frontal craniotomy. Mechanism of such injuri es and appropriate surgical approaches are described as well.