[A case of transorbital intracranial foreign bodies due to windshield impact]

Abstract

A case of transorbital intracranial foreign bodies due to windshield impact was reported. A 17-year-old man was admitted to our department after he had his face injured in a traffic accident. He was fully conscious, and had no neurological deterioration except for a disturbance in his left external ocular movement. Plain skull X-rays and a plain CT revealed foreign bodies in the left orbit and the left frontal lobe. Combined surgery, through the orbit and the subfrontal approach, was performed to remove many foreign bodies (crushed windshield glass). His external ocular movement returned to normal postoperatively. There were no complications of meningitis and liquorrhea, and he was discharged without any neurological deficiency. The law, enacted in 1988, obliges the use of high penetration resistant (H.P.R.) laminated windshield in all new cars in Japan. But many motor cars equipped with partially enhanced windshields are still in use. It should be noted that partially enhanced windshields cause more severe injuries than H.P.R. laminated ones.