We report the case of a 35-year-old man who came to the emergency room after suffering an aggression in the left upper eyelid with a thin, long metallic object while walking on the street.
He had an important ethylic iron and gait instability.
Examination revealed unreliable visual acuity (VA) in the left eye (LE) due to poor patient cooperation, but at least 0.7.
Intrinsic ocular motility was normal.
He did not refer diplopia in any position of gaze.
A small, superficial, contuse, hematoma was observed in the upper extremities, which did not require suture.
Biomycosis, ocular tension and eye fundus were normal.
The patient was left under observation, presenting in the following hours a progressive neurological deterioration, consisting of temporospatial disorientation, inconsistent responses, progressive somnolence and recurrent adjacent vomiting left periorbital haematoma Glasgow Coma Scale SGS 12
1.
Blood tests were performed, which ruled out any hemorrhagic tendency of the patient (bleeding time, prothrombin time, activated partial thromboplastin time, fibrinogen and normal platelets).
A digital subtraction arteriography (DSA) of the brain was performed, in which no pathological findings were found.
1.
The patient was admitted to the Intensive Care Unit.
During admission, control CT and ASD were performed on days 1, 2, 3, 7 and 14, ruling out new rebleeding or vascular lesions.
The patient was discharged with a GCS of 15.
The CT at discharge showed a left frontal hematoma in resolution with a small left frontal component and left frontal intraventricular remains isodense in the left Silvio fissure.
