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Cavernous sinus embolisation prior to removal of penetrating foreign body in a 6-year-old child
Transorbital penetrating foreign bodies are extremely rare in children and may penetrate the cavernous sinus or the underlying internal carotid artery. Parent vessel sacrifice and temporary balloon occlusion are feasible options for managing arterial injury during removal of the foreign body. Even i...
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| Published in: | BMJ case reports 2020-12, Vol.13 (12), p.e237301 |
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| container_issue | 12 |
| container_start_page | e237301 |
| container_title | BMJ case reports |
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| creator | Bhatia, Kartik D French, Heath Olsson, Gemma Tumuluri, Krishna |
| description | Transorbital penetrating foreign bodies are extremely rare in children and may penetrate the cavernous sinus or the underlying internal carotid artery. Parent vessel sacrifice and temporary balloon occlusion are feasible options for managing arterial injury during removal of the foreign body. Even in the absence of arterial injury, the ophthalmologist may encounter significant bleeding from the cavernous sinus deep in their operative field that is difficult to control. We present a case of a 6-year-old child with a stick penetrating the left superior orbit to enter the cavernous sinus but sparing the internal carotid artery. We describe the first reported experience of prophylactic coil embolisation of the cavernous sinus to minimise intraoperative bleeding during transorbital removal of a foreign body with an excellent clinical outcome. |
| doi_str_mv | 10.1136/bcr-2020-237301 |
| format | article |
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Parent vessel sacrifice and temporary balloon occlusion are feasible options for managing arterial injury during removal of the foreign body. Even in the absence of arterial injury, the ophthalmologist may encounter significant bleeding from the cavernous sinus deep in their operative field that is difficult to control. We present a case of a 6-year-old child with a stick penetrating the left superior orbit to enter the cavernous sinus but sparing the internal carotid artery. We describe the first reported experience of prophylactic coil embolisation of the cavernous sinus to minimise intraoperative bleeding during transorbital removal of a foreign body with an excellent clinical outcome.</description><identifier>ISSN: 1757-790X</identifier><identifier>EISSN: 1757-790X</identifier><identifier>DOI: 10.1136/bcr-2020-237301</identifier><identifier>PMID: 33318247</identifier><language>eng</language><publisher>England: BMJ Publishing Group Ltd</publisher><subject>Accidental Injuries ; Balloon Occlusion - methods ; Bicycling ; Cardiac arrhythmia ; Carotid arteries ; Carotid Artery, Internal - surgery ; Case Report ; Case reports ; Cavernous Sinus - pathology ; Child ; Children & youth ; Computed Tomography Angiography ; Dissection ; Embolization ; Fistula ; Foreign bodies ; Foreign Bodies - complications ; Foreign Bodies - surgery ; Head Injuries, Penetrating - surgery ; Humans ; Male ; Medical imaging ; Neurosurgery ; ophthalmology ; Orbit - blood supply ; Orbit - pathology ; Orbit - surgery ; paediatrics ; Pediatrics ; Sinuses ; trauma CNS /PNS ; Veins & arteries</subject><ispartof>BMJ case reports, 2020-12, Vol.13 (12), p.e237301</ispartof><rights>BMJ Publishing Group Limited 2020. No commercial re-use. See rights and permissions. Published by BMJ.</rights><rights>2020 BMJ Publishing Group Limited 2020. No commercial re-use. See rights and permissions. Published by BMJ.</rights><rights>BMJ Publishing Group Limited 2020. No commercial re-use. See rights and permissions. Published by BMJ. 2020</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><cites>FETCH-LOGICAL-b446t-ba62d871729606b8a347c405a31a26137b68d88318597111e8640c522ff3ad5b3</cites><orcidid>0000-0002-3431-5647</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC7737400/pdf/$$EPDF$$P50$$Gpubmedcentral$$H</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC7737400/$$EHTML$$P50$$Gpubmedcentral$$H</linktohtml><link.rule.ids>230,314,723,776,780,881,27901,27902,53766,53768</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/33318247$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Bhatia, Kartik D</creatorcontrib><creatorcontrib>French, Heath</creatorcontrib><creatorcontrib>Olsson, Gemma</creatorcontrib><creatorcontrib>Tumuluri, Krishna</creatorcontrib><title>Cavernous sinus embolisation prior to removal of penetrating foreign body in a 6-year-old child</title><title>BMJ case reports</title><addtitle>BMJ Case Rep</addtitle><addtitle>BMJ Case Rep</addtitle><description>Transorbital penetrating foreign bodies are extremely rare in children and may penetrate the cavernous sinus or the underlying internal carotid artery. Parent vessel sacrifice and temporary balloon occlusion are feasible options for managing arterial injury during removal of the foreign body. Even in the absence of arterial injury, the ophthalmologist may encounter significant bleeding from the cavernous sinus deep in their operative field that is difficult to control. We present a case of a 6-year-old child with a stick penetrating the left superior orbit to enter the cavernous sinus but sparing the internal carotid artery. We describe the first reported experience of prophylactic coil embolisation of the cavernous sinus to minimise intraoperative bleeding during transorbital removal of a foreign body with an excellent clinical outcome.</description><subject>Accidental Injuries</subject><subject>Balloon Occlusion - methods</subject><subject>Bicycling</subject><subject>Cardiac arrhythmia</subject><subject>Carotid arteries</subject><subject>Carotid Artery, Internal - surgery</subject><subject>Case Report</subject><subject>Case reports</subject><subject>Cavernous Sinus - pathology</subject><subject>Child</subject><subject>Children & youth</subject><subject>Computed Tomography Angiography</subject><subject>Dissection</subject><subject>Embolization</subject><subject>Fistula</subject><subject>Foreign bodies</subject><subject>Foreign Bodies - complications</subject><subject>Foreign Bodies - surgery</subject><subject>Head Injuries, Penetrating - surgery</subject><subject>Humans</subject><subject>Male</subject><subject>Medical imaging</subject><subject>Neurosurgery</subject><subject>ophthalmology</subject><subject>Orbit - blood supply</subject><subject>Orbit - pathology</subject><subject>Orbit - surgery</subject><subject>paediatrics</subject><subject>Pediatrics</subject><subject>Sinuses</subject><subject>trauma CNS /PNS</subject><subject>Veins & arteries</subject><issn>1757-790X</issn><issn>1757-790X</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2020</creationdate><recordtype>article</recordtype><recordid>eNqNkUtrGzEUhUVJiI3rdXZF0E1omVqvkTSbQDB9BALZJJCdkGY0tsyM5Ehjg_99ZZy4biAQLaQL99Ph3HsAuMToB8aUz0wdC4IIKggVFOFPYIxFKQpRoaezk3oEpimtUD4UM8noBRhRSrEkTIyBmuutjT5sEkzO59v2JnQu6cEFD9fRhQiHAKPtw1Z3MLRwbb0dYu77BWxDtG7hoQnNDjoPNeTFzupYhK6B9dJ1zWdw3uou2enLOwGPv34-zP8Ud_e_b-c3d4VhjA-F0Zw0UmBBKo64kZoyUTNUaoo14ZgKw2UjZXZdVgJjbCVnqC4JaVuqm9LQCbg-6K43prdNbX322Kk8QK_jTgXt1P8d75ZqEbZKCCpYXs0EXL0IxPC8sWlQvUu17Trtbd6OyttCRKJS4ox-fYOuwib6PF6meMWrquJ7anag6hhSirY9msFI7fNTOT-1z08d8ss_vpzOcORf08rAtwNg-tUH1L7_g48G36P_AhDSr_o</recordid><startdate>20201213</startdate><enddate>20201213</enddate><creator>Bhatia, Kartik D</creator><creator>French, Heath</creator><creator>Olsson, Gemma</creator><creator>Tumuluri, Krishna</creator><general>BMJ Publishing Group Ltd</general><general>BMJ Publishing Group LTD</general><general>BMJ Publishing Group</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7RV</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>BENPR</scope><scope>BTHHO</scope><scope>CCPQU</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>K9.</scope><scope>KB0</scope><scope>M0S</scope><scope>M1P</scope><scope>NAPCQ</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>7X8</scope><scope>5PM</scope><orcidid>https://orcid.org/0000-0002-3431-5647</orcidid></search><sort><creationdate>20201213</creationdate><title>Cavernous sinus embolisation prior to removal of penetrating foreign body in a 6-year-old child</title><author>Bhatia, Kartik D ; 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| subjects | Accidental Injuries Balloon Occlusion - methods Bicycling Cardiac arrhythmia Carotid arteries Carotid Artery, Internal - surgery Case Report Case reports Cavernous Sinus - pathology Child Children & youth Computed Tomography Angiography Dissection Embolization Fistula Foreign bodies Foreign Bodies - complications Foreign Bodies - surgery Head Injuries, Penetrating - surgery Humans Male Medical imaging Neurosurgery ophthalmology Orbit - blood supply Orbit - pathology Orbit - surgery paediatrics Pediatrics Sinuses trauma CNS /PNS Veins & arteries |
| title | Cavernous sinus embolisation prior to removal of penetrating foreign body in a 6-year-old child |
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