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Penetrating injury to the posterior fossa is uncommon, and when it occurs, it is typically due to projectiles that pierce the cranial bones. Morbidity and mortality from these injuries are high. We present 3 cases in which objects that were thrust through the orbit penetrated the upper brainstem. All patients survived their injuries.
Case 1. A 21-year-old man was struck below the left eye by a wire 4 mm in diameter while laying concrete-reinforcing steel mesh. He had a puncture site evident on his left lower lid. He complained of vertical and horizontal diplopia, mild left ptosis, decreased coordination of the right side of his body, and slurred speech.
Quinn LM, Egan RA, Shults WT. Transorbital Penetrating Brainstem Injuries. Arch Ophthalmol. 2006;124(6):915–916. doi:10.1001/archopht.124.6.915
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