小児の経眼窩的頭蓋内穿通外傷の2例

Transorbital cerebral injury in two children

要約　目的：眼窩を貫通して頭蓋内に穿孔性外傷が生じた小児の2症例の報告。症例：1例は5歳女児，他の1例は1歳女児で，いずれも左眼に受傷した。第1例は箸が内眼角近くを貫通し，CTで先端部が頭蓋内にあった。開頭手術で異物を除去した。第2例ははさみを持ったまま転倒し，上眼瞼に裂傷を生じた。嘔吐が続き，受傷翌日のCTで貫通性脳挫傷があり，さらに外傷性脳動脈瘤が発見された。開頭手術が実施され，2症例とも以後の経過は良好である。結論：眼瞼または眼窩の外傷では，異物が頭蓋内に穿通している可能性があり，注意が必要である。

Abstract.　Purpose：To report two children who suffered cerebral injury through the orbit. Cases：Both were females aged five and one year each. Both eye was affected in both cases. In the first case,a chopstick penetrated near the medial canthus. Computed tomography（CT）showed the tip of chopstick in the cranium. It was removed by cerebral surgery. In the second case,the infant fell down holding a pair of scissors in her hand,resulting in laceration in the upper eyelid. The following day,CT showed perforating cerebral injury and traumatic intracranial aneurysm which was eventually treated by surgery. Both cases are doing well at present. Conclusion：Possibility of intracranial damage is to be suspected in perforating trauma to the orbit or the eyelid.