{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T04:02:07Z","timestamp":1787025727838,"version":"build-2736575974"},"reference-count":50,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","issue":"1","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JNS"],"published-print":{"date-parts":[[2011,1]]},"abstract":"<jats:p>Transorbital penetrating injury (TPI), an uncommon subset of head trauma, requires prompt multidisciplinary surgical intervention. While numerous case reports appear in the literature, there is a lack of discrete recommendations for initial evaluation, surgical intervention, and postoperative care of patients with TPI.<\/jats:p>\n                  <jats:p>A retrospective review of 4 cases of TPI at the University of Michigan Health System was undertaken to assess for diagnosis, treatment, and follow-up. In addition, a PubMed search using the terms \u201cpenetrating orbital trauma,\u201d \u201cpenetrating orbital injury,\u201d \u201ctransorbital penetration,\u201d and \u201ctransorbital penetrating injury\u201d were used to search for articles discussing the presentation and management of penetrating orbital trauma.<\/jats:p>\n                  <jats:p>All 4 of the patients at the University of Michigan underwent focused physical examination performed by a multidisciplinary trauma team followed by dedicated maxillofacial and head CT scanning. The patients' treatments varied, depending on the mechanism and extent of the injury. An analysis of the case series presented here as well as other published cases suggests an algorithm for diagnosis and treatment for patients with TPI, which includes focused evaluation, diagnostic imaging with maxillofacial CT scanning, and management of the injury that focuses on the path of penetration and the presence of the foreign body in situ at the time of presentation. Magnetic resonance imaging is indicated in patients who have indwelling wooden foreign bodies. Angiography should be performed in patients with suspected vascular injury. Treatment decisions should be made by a multidisciplinary team with input from neurosurgery, ophthalmology, otolaryngology, and maxillofacial surgery.<\/jats:p>","DOI":"10.3171\/2010.8.jns10301","type":"journal-article","created":{"date-parts":[[2010,9,24]],"date-time":"2010-09-24T11:17:19Z","timestamp":1285327039000},"page":"53-61","source":"Crossref","is-referenced-by-count":80,"title":["Transorbital penetrating injury: case series, review of the literature, and proposed management algorithm"],"prefix":"10.3171","volume":"114","author":[{"given":"Matthew","family":"Schreckinger","sequence":"first","affiliation":[{"name":"Departments of Surgery and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniel","family":"Orringer","sequence":"additional","affiliation":[{"name":"Neurosurgery, University of Michigan Health System, Ann Arbor, Michigan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"B. Gregory","family":"Thompson","sequence":"additional","affiliation":[{"name":"Neurosurgery, University of Michigan Health System, Ann Arbor, Michigan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Frank","family":"La Marca","sequence":"additional","affiliation":[{"name":"Neurosurgery, University of Michigan Health System, Ann Arbor, Michigan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Oren","family":"Sagher","sequence":"additional","affiliation":[{"name":"Neurosurgery, University of Michigan Health System, Ann Arbor, Michigan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1754","reference":[{"key":"b1-jns10301","series-title":"Pediatr Neurosurg","first-page":"498","article-title":"Transorbital orbitocranial penetrating injury due to bicycle brake handle in a child","volume":"43","author":"Agrawal","year":"2007"},{"key":"b2-jns10301","series-title":"Arch Ophthalmol","first-page":"1701","article-title":"Penetrating orbital injury by automobile wiper-control stalk","volume":"118","author":"Ahmad","year":"2000"},{"key":"b3-jns10301","series-title":"Br J Neurosurg","first-page":"368","article-title":"Transorbital penetrating craniocerebral injury by a spectacle arm: suicidal attempts","volume":"17","author":"Al-Anazi","year":"2003"},{"key":"b4-jns10301","series-title":"J Oral Maxillofac Surg","first-page":"229","article-title":"Blindness after facial fractures: a 19-year retrospective study","volume":"63","author":"Ansari","year":"2005"},{"key":"b5-jns10301","series-title":"JAMA","first-page":"1151","article-title":"Orbitofacial wounds and cerebral artery injuries caused by umbrella tips","volume":"239","author":"Carothers","year":"1978"},{"key":"b6-jns10301","series-title":"Graefes Arch Clin Exp Ophthalmol","first-page":"289","article-title":"Sympathetic ophthalmia","volume":"247","author":"Castiblanco","year":"2009"},{"key":"b7-jns10301","series-title":"Acta Neurochir (Wien)","first-page":"937","article-title":"Orbito-cranial injuries caused by penetrating non-missile foreign bodies. 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Feeding cats might be dangerous: penetrating orbital and brain injury without neurological deficits","volume":"76","author":"Knerlich","year":"2005"},{"key":"b24-jns10301","series-title":"J Trauma","first-page":"555","article-title":"Household objects as a cause of self-inflicted orbital apex syndrome","volume":"42","author":"Lasky","year":"1997"},{"key":"b25-jns10301","series-title":"J Chin Med Assoc","first-page":"36","article-title":"Management of transorbital brain injury","volume":"70","author":"Lin","year":"2007"},{"key":"b26-jns10301","series-title":"J Craniofac Surg","first-page":"226","article-title":"Unusual penetrating cranio-orbital injury by a cut-off wheel","volume":"15","author":"Lindner","year":"2004"},{"key":"b27-jns10301","series-title":"Am J Forensic Med Pathol","first-page":"334","article-title":"Suicide by intracerebellar ballpoint pen","volume":"23","author":"Lunetta","year":"2002"},{"key":"b28-jns10301","series-title":"Acta Neurochir (Wien)","first-page":"331","article-title":"Artistic assault: an unusual penetrating head injury reported as a trivial facial trauma","volume":"147","author":"Mandat","year":"2005"},{"key":"b29-jns10301","series-title":"Neurol Med Chir (Tokyo)","first-page":"143","article-title":"Brain abscess following transorbital penetrating injury due to bamboo fragments\u2014case report","volume":"42","author":"Maruya","year":"2002"},{"key":"b30-jns10301","series-title":"AJNR Am J Neuroradiol","first-page":"1163","article-title":"Intracranial penetrating injuries via the optic canal","volume":"19","author":"Matsumoto","year":"1998"},{"key":"b31-jns10301","series-title":"Ann Emerg Med","first-page":"589","article-title":"Occult transorbital intracranial penetrating injuries","volume":"15","author":"Mono","year":"1986"},{"key":"b32-jns10301","series-title":"Br J Ophthalmol","first-page":"374","article-title":"Case of penetrating orbitocranial injury caused by wood","volume":"75","author":"Mutlukan","year":"1991"},{"key":"b33-jns10301","series-title":"J Laryngol Otol","first-page":"548","article-title":"Penetrating injury of the cheek requiring skull base exploration","volume":"116","author":"Patel","year":"2002"},{"key":"b34-jns10301","series-title":"N Engl J Med","first-page":"e3","article-title":"Images in clinical medicine. Penetrating orbital trauma","volume":"358","author":"Reddy","year":"2008"},{"key":"b35-jns10301","series-title":"Skull Base Surg","first-page":"95","article-title":"Craniofacial resection: decreased complication rate with a modified subcranial approach","volume":"9","author":"Ross","year":"1999"},{"key":"b36-jns10301","series-title":"Injury","first-page":"279","article-title":"A case of transorbital intracranial damage underlying a seemingly innocuous injury","volume":"26","author":"Sadiq","year":"1995"},{"key":"b37-jns10301","series-title":"Neurol India","first-page":"331","article-title":"Transorbital penetrating cerebral injury with a ceramic stone: report of an interesting case","volume":"57","author":"Satyarthee","year":"2009"},{"key":"b38-jns10301","series-title":"J Oral Maxillofac Surg","first-page":"98","article-title":"Fan blade injury to the maxillofacial region: a case report","volume":"56","author":"Sedhom","year":"1998"},{"key":"b39-jns10301","series-title":"J Craniomaxillofac Surg","first-page":"353","article-title":"Trans-orbital penetrating head injury with a door key","volume":"25","author":"Seex","year":"1997"},{"key":"b40-jns10301","series-title":"Neurosurg Rev","first-page":"115","article-title":"Combined orbito-frontal injuries","volume":"12","author":"Sollmann","year":"1989"},{"key":"b41-jns10301","series-title":"Emerg Radiol","first-page":"109","article-title":"Self-inflicted transorbital and intracranial injury from eyeglasses","volume":"10","author":"Strub","year":"2003"},{"key":"b42-jns10301","series-title":"Ann Emerg Med","first-page":"568","article-title":"Penetrating intracranial trauma from a fishhook","volume":"21","author":"Swanson","year":"1992"},{"key":"b43-jns10301","series-title":"J Neurosurg Pediatr","first-page":"420","article-title":"Supraorbital approach for repair of open anterior skull base fracture. Case report","volume":"2","author":"Szabo","year":"2008"},{"key":"b44-jns10301","series-title":"AJR Am J Roentgenol","first-page":"144","article-title":"Orbital assault with a pencil: evaluating vascular injury","volume":"173","author":"Tenenholz","year":"1999"},{"key":"b45-jns10301","series-title":"Surv Ophthalmol","first-page":"449","article-title":"Patterns of transorbital intracranial injury: a review and comparison of occult and non-occult cases","volume":"51","author":"Turbin","year":"2006"},{"key":"b46-jns10301","series-title":"J Trauma","first-page":"788","article-title":"Successful recovery after an orbitocranial injury","volume":"49","author":"Vaicys","year":"2000"},{"key":"b47-jns10301","series-title":"South Med J","first-page":"116","article-title":"Penetrating orbital trauma with internal carotid injury","volume":"102","author":"Walid","year":"2009"},{"key":"b48-jns10301","series-title":"J Neuroophthalmol","first-page":"48","article-title":"Transorbital intracranial penetrating injury from impaling on an earpick","volume":"27","author":"Yamashita","year":"2007"},{"key":"b49-jns10301","series-title":"Curr Opin Ophthalmol","first-page":"490","article-title":"Orbital apex syndrome","volume":"15","author":"Yeh","year":"2004"},{"key":"b50-jns10301","series-title":"Arch Ophthalmol","first-page":"254","article-title":"Corneal rust ring. Etiology and histology","volume":"63","author":"Zuckerman","year":"1960"}],"container-title":["Journal of Neurosurgery"],"original-title":[],"link":[{"URL":"https:\/\/thejns.org\/view\/journals\/j-neurosurg\/114\/1\/article-p53.xml","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/thejns.org\/downloadpdf\/journals\/j-neurosurg\/114\/1\/article-p53.xml","content-type":"text\/html","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/thejns.org\/downloadpdf\/journals\/j-neurosurg\/114\/1\/article-p53.xml","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,3,27]],"date-time":"2023-03-27T02:06:51Z","timestamp":1679882811000},"score":1,"resource":{"primary":{"URL":"https:\/\/thejns.org\/view\/journals\/j-neurosurg\/114\/1\/article-p53.xml"}},"subtitle":["Report of 4 cases"],"short-title":[],"issued":{"date-parts":[[2011,1]]},"references-count":50,"journal-issue":{"issue":"1"},"URL":"https:\/\/doi.org\/10.3171\/2010.8.jns10301","relation":{},"ISSN":["0022-3085","1933-0693"],"issn-type":[{"value":"0022-3085","type":"print"},{"value":"1933-0693","type":"electronic"}],"subject":[],"published":{"date-parts":[[2011,1]]}}}