PMC7689382_01
Imaging of X-ray and computed tomography (CT). (A) X-ray indicating the presence and position of a linear foreign body (FB). (B) CT revealing a strip-shaped focus and high-density areas in the adjacent areas. (C,D) The FB had pierced the left orbital apex and compressed the left transverse sinus. (E,F) The FB had penetrated the superior orbital fissure and cavernous sinus, in close proximity to the internal carotid artery (ICA). (G) Discontinuity of the cavernous segment of ICA. (H) Discontinuity in a portion of the left transverse sinus.
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F1
CT arteriography (CTA) revealed that the FB was close to the inner wall of the cavernous sinus segment of the left ICA. CT venography (CTV) showed that the tip of the FB was compressing the left transverse sinus (Figure 1).
Imaging of digital subtraction angiography. (A) Focal compression of the C4 segment of the left internal carotid artery but no leakage of the contrast agent. (B) A poor developing transverse sinus with no leakage.
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F2
Digital subtraction angiography (DSA) suggested that compressive stenosis had occurred in the C4 segment of the left ICA with no sign of rupture, and the distal branches of left ICA were slightly sparse (Figure 2A). The left transverse sinus was also compressed but no rupture was observed (Figure 2B).
Postoperative computed tomography (CT). (A,B) CT scan revealing postoperative changes and high-density shade in the areas of the cavernous sinus region and cerebellum. (C) A high-density focus in the lateral ventricle.
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F3
The ICP probe maintained proper drainage and was correctly positioned in the lateral ventricle (Figure 3).
Postoperative photos. (A) Surgical removal of the plastic rod and appearance of both eyelids and palpebral fissures (B) Status at discharge. (C) Status at 3 months after surgery.
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F4
The FB was completely removed (Figure 4A). At the time of discharge, she fully regained her consciousness, but still exhibited eye adduction, blepharoptosis (the eyelid fissure 4 mm), and dilated pupil with the absence of direct and indirect light reflexes on the left side (Figure 4B). The left drooped eyelid fissure measured 6 mm across, but had improved and was slightly narrower than the right fissure (Figure 4C).