眼窩壁を穿破した脳内異物および脳損傷の2例

Penetrating Transorbital Brain Injury and Intracranial Foreign Body

Ⅰ．はじめに

　経眼窩的脳損傷による骨片・異物の脳内穿通は，平時にはまれであり^5），脳神経外科医の診療対象となることは少ない．初期治療は，多くの場合，眼科医あるいは救急にたずさわる医師により行なわれるが，時には脳損傷を看過されるために，重篤な合併症を来たして予後不良となる^2,21）．

　著者らは，最近，2例の経眼窩的脳損傷を経験し，文献上集計しえた73例^{1-4,8,10,12,20,22-27）}と共に，本症の臨床的特徴について考察を加えた．

Two case of transorhital brain injury were reported.

A 43-year-old man was admitted to our department 4 hours after the injury to his left eye with a small piece of wood. His consciousness was slightly disturbed and plain skull X-ray revealed a fracture of the orbital roof. The bone fragments were supposed to stick and sink into the left frontal lobe. Then an emergency operation was performed. The bone fragments dislocated from the orbital roof were removed and suhtemporal decompression was performed. He became fully conscious about 2 weeks after operation. On discharge the neurological examination was entirely negative.