Self-inflicted enucleations: Clinical features of seven cases
| العنوان: | Self-inflicted enucleations: Clinical features of seven cases |
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| المؤلفون: | Ronald Mancini, Roman Shinder, Lucy Sun, Solly Elmann, Jacqueline R. Carrasco, Ivan Vrcek, Mamta Shah, Hee Joon Kim |
| المصدر: | Orbit. 36:154-158 |
| بيانات النشر: | Informa UK Limited, 2017. |
| سنة النشر: | 2017 |
| مصطلحات موضوعية: | Adult, Male, medicine.medical_specialty, Schizoaffective disorder, Eye Enucleation, 03 medical and health sciences, 0302 clinical medicine, medicine, Humans, Depression (differential diagnoses), Aged, Retrospective Studies, Ultrasonography, medicine.diagnostic_test, business.industry, Retrospective cohort study, Middle Aged, medicine.disease, Magnetic Resonance Imaging, Substance-induced psychosis, Surgery, Ophthalmology, medicine.anatomical_structure, Angiography, Self Mutilation, 030221 ophthalmology & optometry, Optic nerve, Etiology, Female, Eyelid, Tomography, X-Ray Computed, business, Orbit, Self-Injurious Behavior, 030217 neurology & neurosurgery, Orbital Implants |
| الوصف: | We report the clinical presentation, radiography, and management outcomes of autoenucleations (AE). Charts of 7 patients evaluated at 4 institutions with AE were reviewed. Four males and three females had a mean age of 50 years (range 26-72 years). The etiologies were psychosis secondary to underlying mental illness (6, 88%) and substance use (1, 12%), and the mechanism was largely blunt digital injury (6, 88%). Three (43%) AE patients suffered bilateral enucleations. Common concomitant injuries included eyelid lacerations (5, 71%) and optic nerve avulsion (3, 43%). Radiography was utilized for all of the study patients with computed tomography as the most common (5, 71%), followed by ultrasound (1, 14%), and magnetic resonance imaging with CT angiography (1, 14). Orbital exploration was performed in the management of all patients. Orbital implants were placed in 4 (57%) patients. Patients were followed for a mean of 1.9 months (range 1-4 months). Autoenucleation affects both genders and is commonly associated with eyelid lacerations, optic nerve avulsion, and intracranial hemorrhage. The association with intracranial hemorrhage is consistent with prior reports of internal carotid artery injury following shearing of the optic nerve. Autoenucleation cases were seen secondary to mental or substance induced psychosis, and these patients may be at risk for future injuries such as AE of the contralateral globe. The common causes for psychosis reported our patient group include schizophrenia, depression, schizoaffective disorder, and methamphetamine-induced psychosis, which corroborates with similar cases in the literature. Two of three cases of bilateral AE suffered sequential AE where the contralateral globe was enucleated days apart. All patients suffering AE should have full medical, psychiatric, neurologic, and radiologic evaluation and monitoring while under care. When evaluating patients with obvious ocular injury, accompanying intracranial injuries should be ruled out in a timely fashion before pursuing surgical intervention. |
| تدمد: | 1744-5108 0167-6830 |
| URL الوصول: | https://explore.openaire.eu/search/publication?articleId=doi_dedup___::4a0e692fcc5a3fe0bceb5fcd1453f3c7 https://doi.org/10.1080/01676830.2017.1279670 |
| رقم الأكسشن: | edsair.doi.dedup.....4a0e692fcc5a3fe0bceb5fcd1453f3c7 |
| قاعدة البيانات: | OpenAIRE |
PDF full text from Publisher | تدمد: | 17445108 01676830 |
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