Transorbital penetrating head injury by a toilet brush handle

BACKGROUND: Transorbital penetrating brain injuries are rare lesions without defined therapy standards. CLINICAL PRESENTATION AND INTERVENTION: A male patient presented at our institution with a toilet brush handle in the right cerebral hemisphere. CT imaging identified the object entering the right orbit and having crossed the right hemisphere in the ventricular plane. After performing a medium-sized craniotomy, the object was removed step-by-step under monitoring with an intraoperative CT scan to ensure no involving major hemorrhage. CONCLUSION: Transorbital penetrating brain injuries are treated best by utilizing all up-to-date technical developments such as intraoperative CT-scanning to increase the safety in the management of such exceptional lesions with increased risk of immediate life-threatening intracranial bleeding.