Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Case Reports
. 2024 Oct 25:15:379.
doi: 10.25259/SNI_618_2024. eCollection 2024.

Transorbital subfrontal arrowhead injury: Experience in a low-resource setting

Emmanuel Garba Sunday  1 , Temitope Mariam Gbadegesin  2 , Daniel Wycliffe  3 , Bala Nasir Muhammad  3
Affiliations
Case Reports

Transorbital subfrontal arrowhead injury: Experience in a low-resource setting

Emmanuel Garba Sunday et al. Surg Neurol Int. .

Abstract

Background: With the insurgency and farmer-herder crisis in northeast Nigeria, arrow injuries with various fatalities have been on the increase. Practicing in a low-resource setting with no functional computed tomography (CT) scan necessitates utmost dependence on plain X-rays for decision-making in patient care.

Case description: We present our experience with a patient who presented in our facility with a right transorbital subfrontal arrow injury. The patient had retrograde extraction of the arrow based on plain X-ray findings with no sequelae.

Conclusion: We highlighted the role of X-ray in the management of arrow injuries, although bone window CT without or with angiography is the gold standard of imaging modalities in the management of patients with arrow injuries to the head.

Keywords: Arrow injury; Low-resource setting; Subfrontal; Transorbital; X-rays.

PubMed Disclaimer

Conflict of interest statement

There are no conflicts of interest.

Figures

Figure 1:
Figure 1:
(a) The 50-year-old man with right medial canthus (upper eyelid) transorbital intracranial arrow injury following farmer-herders crisis; skull x-ray (b) Showing transorbital subfrontal arrowhead impalement just lateral to the right frontal sinus, (c) with subfrontal aerocele.
Figure 2:
Figure 2:
Intra-operative process - (a) Patient draped with an arrow in situ; (b) soft-tissue dissection around the arrow; (c) arrow retrogradely extracted with no cerebrospinal fluid egress following Valsalva maneuver; (d) Wound closed in layers; (e) extracted arrow.
Figure 3:
Figure 3:
Sutures removed 10th postoperative day.
See this image and copyright information in PMC

References

    1. Abdullahi H, Adamu A, Hasheem MG. Penetrating arrow injuries of the head-and-neck region: Case series and review of literature. Niger Med J. 2020;61:276–80. - PMC - PubMed
    1. Adamu A, Garandawa HI, Nuhu AM, Farate A, Kodiya AM, Abdulrazaq A, et al. A review of arrow shot injuries to the head and neck in Northeastern Nigeria. Borno Med J. 2021;18:1–7.
    1. Aref M, Kunigelis KE, Yang A, Subramanian PS, Ramakrishnan VR, Youssef AS. The effect of preoperative direct ligation of ethmoidal arteries on the perioperative outcomes of large anterior skull base meningiomas surgery: A clinical study. World Neurosurg. 2018;120:e776–82. - PubMed
    1. Bill JH. Sabre and Bayonnete wounds, arrow wounds. In: Arshhust J, editor. The International Encyclopedia of Surgery: A systematic treatise on the theory and practice of surgery. Vol. 2. United States: William Wood; 1882. pp. 101–7.
    1. De Jongh K, Dohmen D, Salgado R, Ozsarlak O, Van Goethem JW, Beaucourt L, et al. “William Tell” injury: MDCT of an arrow through the head. AJR Am J Roentgenol. 2004;182:1551–3. - PubMed

Publication types

LinkOut - more resources