Fencing unmasked: A case of penetrating cranio-orbital injury

Abstract

Introduction: Transorbital low-velocity penetrating head injuries are uncommon but important. Minor skin wounds may herald intracranial injury with high morbidity and mortality. Case presentation: A fencing coach was pierced by a sabre between his nose and right eye resulting in orbital roof fracture and frontal lobe laceration. With prompt recognition of these injuries under multidisciplinary management, he attained uncomplicated recovery. Conclusion: The emergency physician should maintain a high index of suspicion for intracranial injury in patients presenting with history of penetrating head injury. Understanding orbital anatomy, injury mechanisms and patterns can facilitate timely management to prevent potentially sight-threatening and life-threatening complications.