case_images: PMC2822793_01
case_images: Photograph of the tip of the umbrella. The metal tip of umbrella is approximate 70 mm in length and 8 mm in diameter (bar = 10 mm).
case_images: 1752-1947-4-18-1.jpg
case_images: PMC2822793_01_1752-1947-4-18-1.jpg
case_images: F1
case_images: On a day prior to her visit the woman's younger brother had been playing with an umbrella, which subsequently caused the handle to detach and the metal tip of the umbrella (figure 1) to strike the woman in her upper right eyelid.
case_images: Computerized tomographic and magnetic resonance images of the patient's brain. A) This computed tomography (CT) scan shows incarcerated orbital bone fragment (arrow) and brain contusion. B) This three-dimensional CT scan shows a window defect caused by a fracture (arrow) of the superior orbital wall. C) This magnetic resonance image (MRI) shows the brain edema in greater detail (arrowhead). D) This MRI sagittal section shows where the umbrella tip had penetrated through the periorbital puncture (arrowhead).
case_images: 1752-1947-4-18-2.jpg
case_images: PMC2822793_01_1752-1947-4-18-2.jpg
case_images: F2
case_images: The signals were interpreted as brain edema, and the high-density area, which was isodense with bone and located anteriorly to the third ventricle, represented orbital bone fragments; no other foreign body was detected on cross-sectional CT scanning (Figure 2a). On three-dimensional CT scanning a window defect became apparent in the superior orbital wall (Figure 2b). MRI on the same day demonstrated edema of the head of the caudate nucleus and putamen, and the edema extended to the hypothalamus, where the bone fragments had penetrated into the brain cavity through the inferior part of the frontal lobe (Figures 2c, d).
case_images: Photograph of right eye lid. Photograph of the patient's right eye lid three months after the injury. The width of the perforating injury is approximately 2 cm (arrowheads).
case_images: 1752-1947-4-18-3.jpg
case_images: PMC2822793_01_1752-1947-4-18-3.jpg
case_images: F3
case_images: The retina remained attached in the right eye three months later, with full ocular movement and a minor scar of width approximately 2 cm at the superior eyelid (Figure 3).