{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,29]],"date-time":"2026-01-29T23:31:50Z","timestamp":1769729510432,"version":"3.49.0"},"reference-count":34,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","issue":"25","license":[{"start":{"date-parts":[[2024,12,16]],"date-time":"2024-12-16T00:00:00Z","timestamp":1734307200000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["J Cosmet Laser Ther"],"published-print":{"date-parts":[[2024,12,16]]},"abstract":"\n BACKGROUND<\/jats:title>\n Transorbital penetrating brain injury (PBI) accompanied by electrical injury is an extremely rare presentation. This type of traumatic injury has a unique set of diagnostic and therapeutic challenges due to the potential multiple organ system involvement and severe neurological complications.<\/jats:p>\n <\/jats:sec>\n \n OBSERVATIONS<\/jats:title>\n A 50-year-old male experienced a high-impact injury from a welding spike that penetrated the orbit just above the eyeball with a concurrent electrical injury; the electricity exited through the great toe. Initial assessments revealed extensive subarachnoid pneumocephalus and a linear hemorrhage extending from the left medial orbital wall through the ethmoid air cells to the right thalamic nucleus. Remarkably, the eye itself was not injured given the superior trajectory of the spike within the orbit.<\/jats:p>\n <\/jats:sec>\n \n LESSONS<\/jats:title>\n PBIs and electrical injuries usually cause serious sequelae, but the welding spike and electrical current managed to avoid major neuroanatomical structures and visceral organs, allowing the patient to recover with minimal deficits.<\/jats:p>\n \n https:\/\/thejns.org\/doi\/10.3171\/CASE24418<\/jats:ext-link>\n <\/jats:p>\n <\/jats:sec>","DOI":"10.3171\/case24418","type":"journal-article","created":{"date-parts":[[2024,12,16]],"date-time":"2024-12-16T01:49:15Z","timestamp":1734313755000},"source":"Crossref","is-referenced-by-count":0,"title":["Integrated management of concurrent traumatic penetrating brain injury and electrical injury: illustrative case"],"prefix":"10.3171","volume":"8","author":[{"given":"Laureen K.","family":"Raelly-Muze","sequence":"first","affiliation":[{"name":"University of Texas Health San Antonio, San Antonio, Texas"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rafael A.","family":"Vega","sequence":"additional","affiliation":[{"name":"Divison of Neurosurgery, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Leslie M.","family":"Hutchins","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Hendrick Medical Center, Abilene, Texas"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1754","reference":[{"key":"bib1","series-title":"Clin Ophthalmol Auckl NZ","first-page":"1103","article-title":"Surgical treatment of a transorbital penetrating brain injury","volume":"4","author":"Paiva","year":"2010","unstructured":"Paiva WSMonaco BPrudente M, et al. Surgical treatment of a transorbital penetrating brain injury. Clin Ophthalmol Auckl NZ. 2010;4:1103-1105."},{"issue":"2","key":"bib2","series-title":"J Neurosci Rural Pract","first-page":"178","article-title":"Transorbital orbitocranial penetrating injury caused by a metal bar","volume":"3","author":"Arslan","year":"2012","unstructured":"Arslan MEseo\u011flu MG\u00fcd\u00fc BODemir I. Transorbital orbitocranial penetrating injury caused by a metal bar. J Neurosci Rural Pract. 2012;3(2):178-181."},{"issue":"4","key":"bib3","series-title":"No Shinkei Geka","first-page":"433","article-title":"Transorbital penetrating brain injury","volume":"20","author":"Kasamo","year":"1992","unstructured":"Kasamo SAsakura TKusumoto K, et al. Transorbital penetrating brain injury. Article in Japanese. No Shinkei Geka. 1992;20(4):433-438."},{"key":"bib4","series-title":"StatPearls","article-title":"Electrical injuries","author":"Zemaitis","year":"2024","unstructured":"Zemaitis MRForis LALopez RAHuecker MR. Electrical injuries. In: StatPearls. StatPearls Publishing; 2024. Accessed May 3, 2024. http:\/\/www.ncbi.nlm.nih.gov\/books\/NBK448087\/"},{"key":"bib5","series-title":"World Neurosurg","first-page":"26","article-title":"Orbitocranial low-velocity penetrating injury: a personal experience, case series, review of the literature, and proposed management plan","volume":"87","author":"Mzimbiri","year":"2016","unstructured":"Mzimbiri JMLi JBajawi MALan SChen FLiu J. Orbitocranial low-velocity penetrating injury: a personal experience, case series, review of the literature, and proposed management plan. World Neurosurg. 2016;87:26-34."},{"issue":"5","key":"bib6","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","unstructured":"Turbin REMaxwell DNLanger PD, et al. Patterns of transorbital intracranial injury: a review and comparison of occult and non-occult cases. Surv Ophthalmol. 2006;51(5):449-460."},{"issue":"10","key":"bib7","series-title":"Med (Baltim)","first-page":"e14528","article-title":"Diagnosis and treatment of a penetrating brain injury caused by a welding electrode: a case report","volume":"98","author":"Shi","year":"2019","unstructured":"Shi LSun YChen LXue HZhang WYang H. Diagnosis and treatment of a penetrating brain injury caused by a welding electrode: a case report. Med (Baltim). 2019;98(10):e14528."},{"key":"bib8","series-title":"Ann Med Surg (Lond)","first-page":"102937","article-title":"An extremely rare case: transorbital penetrating intracranial injury by wooden foreign body. Case report","volume":"71","author":"Wahyudi","year":"2021","unstructured":"Wahyudi ZAZaky AAIslam AAPrihantonoRosyidi RM. An extremely rare case: transorbital penetrating intracranial injury by wooden foreign body. Case report. Ann Med Surg (Lond). 2021;71:102937."},{"issue":"2","key":"bib9","series-title":"Craniomaxillofac Trauma Reconstr","first-page":"145","article-title":"Transorbital orbitocranial penetrating injury with an iron rod","volume":"9","author":"Agrawal","year":"2016","unstructured":"Agrawal AReddy VUKumar SSHegde KVRao GM. Transorbital orbitocranial penetrating injury with an iron rod. Craniomaxillofac Trauma Reconstr. 2016;9(2):145-148."},{"key":"bib10","series-title":"Ann Med Surg (Lond)","first-page":"183","article-title":"Transorbital-penetrating intracranial injury due to a homemade metal arrow: a case report","volume":"57","author":"Prasetyo","year":"2020","unstructured":"Prasetyo EOley MCSumual VFaruk M. Transorbital-penetrating intracranial injury due to a homemade metal arrow: a case report. Ann Med Surg (Lond). 2020;57:183-189."},{"issue":"1","key":"bib11","series-title":"J Neurosurg","first-page":"53","article-title":"Transorbital penetrating injury: case series, review of the literature, and proposed management algorithm","volume":"114","author":"Schreckinger","year":"2011","unstructured":"Schreckinger MOrringer DThompson BGLa Marca FLSagher O. Transorbital penetrating injury: case series, review of the literature, and proposed management algorithm. J Neurosurg. 2011;114(1):53-61."},{"key":"bib12","series-title":"Case Rep Ophthalmol Med","first-page":"742186","article-title":"Transorbital craniocerebral occult penetrating injury with cerebral abscess complication","volume":"2012","author":"Abdulbaki","year":"2012","unstructured":"Abdulbaki AAl-Otaibi FAlmalki AAlohaly NBaeesa S. Transorbital craniocerebral occult penetrating injury with cerebral abscess complication. Case Rep Ophthalmol Med. 2012;2012:742186."},{"issue":"3","key":"bib13","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","unstructured":"Maruya JYamamoto KWakai MKaneko U. Brain abscess following transorbital penetrating injury due to bamboo fragments\u2014case report. Neurol Med Chir (Tokyo). 2002;42(3):143-146."},{"issue":"1","key":"bib14","series-title":"J Neurosurg","first-page":"219","article-title":"Arterial injuries after penetrating brain injury in civilians: risk factors on admission head computed tomography","volume":"122","author":"Bodanapally","year":"2015","unstructured":"Bodanapally UKSaksobhavivat NShanmuganathan KAarabi BRoy AK. Arterial injuries after penetrating brain injury in civilians: risk factors on admission head computed tomography. J Neurosurg. 2015;122(1):219-226."},{"key":"bib15","series-title":"StatPearls","article-title":"Magnetic resonance imaging contraindications","author":"Ghadimi","year":"2024","unstructured":"Ghadimi MSapra A. Magnetic resonance imaging contraindications. In: StatPearls. StatPearls Publishing; 2024. Accessed August 4, 2024. http:\/\/www.ncbi.nlm.nih.gov\/books\/NBK551669\/"},{"issue":"1","key":"bib16","series-title":"Neurol Neurochir Pol","first-page":"12","article-title":"Neurological and neurourological complications of electrical injuries","volume":"55","author":"Yiannopoulou","year":"2021","unstructured":"Yiannopoulou KGPapagiannis GITriantafyllou AI, et al. Neurological and neurourological complications of electrical injuries. Neurol Neurochir Pol. 2021;55(1):12-23."},{"issue":"3","key":"bib17","series-title":"Craniomaxillofac Trauma Reconstr","first-page":"172","article-title":"Penetrating foreign bodies in head and neck trauma: a surgical challenge","volume":"11","author":"Voss","year":"2018","unstructured":"Voss JOThieme NDoll C, et al. Penetrating foreign bodies in head and neck trauma: a surgical challenge. Craniomaxillofac Trauma Reconstr. 2018;11(3):172-182."},{"key":"bib1","series-title":"Clin Ophthalmol Auckl NZ","first-page":"1103","article-title":"Surgical treatment of a transorbital penetrating brain injury","volume":"4","author":"Paiva","year":"2010","unstructured":"Paiva WSMonaco BPrudente M, et al. Surgical treatment of a transorbital penetrating brain injury. Clin Ophthalmol Auckl NZ. 2010;4:1103-1105."},{"issue":"2","key":"bib2","series-title":"J Neurosci Rural Pract","first-page":"178","article-title":"Transorbital orbitocranial penetrating injury caused by a metal bar","volume":"3","author":"Arslan","year":"2012","unstructured":"Arslan MEseo\u011flu MG\u00fcd\u00fc BODemir I. Transorbital orbitocranial penetrating injury caused by a metal bar. J Neurosci Rural Pract. 2012;3(2):178-181."},{"issue":"4","key":"bib3","series-title":"No Shinkei Geka","first-page":"433","article-title":"Transorbital penetrating brain injury","volume":"20","author":"Kasamo","year":"1992","unstructured":"Kasamo SAsakura TKusumoto K, et al. Transorbital penetrating brain injury. Article in Japanese. No Shinkei Geka. 1992;20(4):433-438."},{"key":"bib4","series-title":"StatPearls","article-title":"Electrical injuries","author":"Zemaitis","year":"2024","unstructured":"Zemaitis MRForis LALopez RAHuecker MR. Electrical injuries. In: StatPearls. StatPearls Publishing; 2024. Accessed May 3, 2024. http:\/\/www.ncbi.nlm.nih.gov\/books\/NBK448087\/"},{"key":"bib5","series-title":"World Neurosurg","first-page":"26","article-title":"Orbitocranial low-velocity penetrating injury: a personal experience, case series, review of the literature, and proposed management plan","volume":"87","author":"Mzimbiri","year":"2016","unstructured":"Mzimbiri JMLi JBajawi MALan SChen FLiu J. Orbitocranial low-velocity penetrating injury: a personal experience, case series, review of the literature, and proposed management plan. World Neurosurg. 2016;87:26-34."},{"issue":"5","key":"bib6","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","unstructured":"Turbin REMaxwell DNLanger PD, et al. Patterns of transorbital intracranial injury: a review and comparison of occult and non-occult cases. Surv Ophthalmol. 2006;51(5):449-460."},{"issue":"10","key":"bib7","series-title":"Med (Baltim)","first-page":"e14528","article-title":"Diagnosis and treatment of a penetrating brain injury caused by a welding electrode: a case report","volume":"98","author":"Shi","year":"2019","unstructured":"Shi LSun YChen LXue HZhang WYang H. Diagnosis and treatment of a penetrating brain injury caused by a welding electrode: a case report. Med (Baltim). 2019;98(10):e14528."},{"key":"bib8","series-title":"Ann Med Surg (Lond)","first-page":"102937","article-title":"An extremely rare case: transorbital penetrating intracranial injury by wooden foreign body. Case report","volume":"71","author":"Wahyudi","year":"2021","unstructured":"Wahyudi ZAZaky AAIslam AAPrihantonoRosyidi RM. An extremely rare case: transorbital penetrating intracranial injury by wooden foreign body. Case report. Ann Med Surg (Lond). 2021;71:102937."},{"issue":"2","key":"bib9","series-title":"Craniomaxillofac Trauma Reconstr","first-page":"145","article-title":"Transorbital orbitocranial penetrating injury with an iron rod","volume":"9","author":"Agrawal","year":"2016","unstructured":"Agrawal AReddy VUKumar SSHegde KVRao GM. Transorbital orbitocranial penetrating injury with an iron rod. Craniomaxillofac Trauma Reconstr. 2016;9(2):145-148."},{"key":"bib10","series-title":"Ann Med Surg (Lond)","first-page":"183","article-title":"Transorbital-penetrating intracranial injury due to a homemade metal arrow: a case report","volume":"57","author":"Prasetyo","year":"2020","unstructured":"Prasetyo EOley MCSumual VFaruk M. Transorbital-penetrating intracranial injury due to a homemade metal arrow: a case report. Ann Med Surg (Lond). 2020;57:183-189."},{"issue":"1","key":"bib11","series-title":"J Neurosurg","first-page":"53","article-title":"Transorbital penetrating injury: case series, review of the literature, and proposed management algorithm","volume":"114","author":"Schreckinger","year":"2011","unstructured":"Schreckinger MOrringer DThompson BGLa Marca FLSagher O. Transorbital penetrating injury: case series, review of the literature, and proposed management algorithm. J Neurosurg. 2011;114(1):53-61."},{"key":"bib12","series-title":"Case Rep Ophthalmol Med","first-page":"742186","article-title":"Transorbital craniocerebral occult penetrating injury with cerebral abscess complication","volume":"2012","author":"Abdulbaki","year":"2012","unstructured":"Abdulbaki AAl-Otaibi FAlmalki AAlohaly NBaeesa S. Transorbital craniocerebral occult penetrating injury with cerebral abscess complication. Case Rep Ophthalmol Med. 2012;2012:742186."},{"issue":"3","key":"bib13","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","unstructured":"Maruya JYamamoto KWakai MKaneko U. Brain abscess following transorbital penetrating injury due to bamboo fragments\u2014case report. Neurol Med Chir (Tokyo). 2002;42(3):143-146."},{"issue":"1","key":"bib14","series-title":"J Neurosurg","first-page":"219","article-title":"Arterial injuries after penetrating brain injury in civilians: risk factors on admission head computed tomography","volume":"122","author":"Bodanapally","year":"2015","unstructured":"Bodanapally UKSaksobhavivat NShanmuganathan KAarabi BRoy AK. Arterial injuries after penetrating brain injury in civilians: risk factors on admission head computed tomography. J Neurosurg. 2015;122(1):219-226."},{"key":"bib15","series-title":"StatPearls","article-title":"Magnetic resonance imaging contraindications","author":"Ghadimi","year":"2024","unstructured":"Ghadimi MSapra A. Magnetic resonance imaging contraindications. In: StatPearls. StatPearls Publishing; 2024. Accessed August 4, 2024. http:\/\/www.ncbi.nlm.nih.gov\/books\/NBK551669\/"},{"issue":"1","key":"bib16","series-title":"Neurol Neurochir Pol","first-page":"12","article-title":"Neurological and neurourological complications of electrical injuries","volume":"55","author":"Yiannopoulou","year":"2021","unstructured":"Yiannopoulou KGPapagiannis GITriantafyllou AI, et al. Neurological and neurourological complications of electrical injuries. Neurol Neurochir Pol. 2021;55(1):12-23."},{"issue":"3","key":"bib17","series-title":"Craniomaxillofac Trauma Reconstr","first-page":"172","article-title":"Penetrating foreign bodies in head and neck trauma: a surgical challenge","volume":"11","author":"Voss","year":"2018","unstructured":"Voss JOThieme NDoll C, et al. Penetrating foreign bodies in head and neck trauma: a surgical challenge. 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