Man recovers from knife wound that passed through his eye into his brain
Doctors have described in BMJ Case Reports a man who made a full recovery after a knife penetrated through his eye into his brain. How the injury happened remains unclear.
A case report in the medical journal BMJ Case Reports describes a man who survived a serious penetrating brain injury in which a knife passed through his eye and into his brain. His doctors say the recovery was far better than the severity of the wound would suggest, and they present it as a rare, unexpected outcome.
Recovery in hospital
After surgery, the patient was moved to intensive care, where he recovered quickly. A day after the operation, doctors removed his breathing tube. He had some mild weakness on his right side, but it resolved two days later.
Brain scans showed steady improvement: a little bleeding and swelling, plus some air in the brain tissue along the path of the knife. Otherwise the tissue appeared to be healing. He developed no infections and had no seizures.
His language function was preserved, and he had no loss of movement or coordination. He was discharged, and at follow-up visits he remained neurologically well, with ongoing eye and mental health care.
Cause of injury unknown
His doctors still do not know how the injury happened, writing that the mechanism is unclear. They noted that he had a history of depression.
Injuries passing through the eye into the brain are rare, and when they occur they usually involve high-velocity mechanisms such as gunshots. Knives, rods and nails fall into the rarer low-velocity category. Such injuries carry substantial risk of illness and death because of hemorrhage, vascular injury, abscess, meningitis, cerebrospinal fluid leak, seizures and neurological deficit.
The authors cited other unexpected recoveries, including Phineas Gage, a railroad foreman who survived an 1848 accident in which an iron rod went through his head. Gage's personality was said to have changed afterward; the doctors in the knife case did not mention any such changes.
The doctors concluded that outcome may depend less on external severity than on the precise trajectory relative to critical vascular, cortical and subcortical structures.
