Orbito-cranial penetrating head injury by tear gas canister: A case report.

Background: Orbito-cranial penetrating injuries caused by tear gas canisters (TGCs) are rare but devastating incidents. These injuries combine severe kinetic trauma with chemical irritation, resulting in complex neurosurgical emergencies that demand prompt multidisciplinary intervention. Case Description: This report describes a 27-year-old male who sustained a penetrating orbital injury from a TGC during a protest. The patient presented with a Glasgow Coma Scale (GCS) score of 9, a fractured skull, herniated brain tissue, and multiple intracranial hemorrhages. Emergency craniotomy was performed, including hematoma evacuation, removal of the canister and bone fragments, and reconstruction of the skull base. Despite initial stabilization, the patient's condition deteriorated postoperatively, leading to sudden cardiac arrest on day three. Tear gas canisters, commonly used for riot control, can cause severe orbito-cranial injuries when deployed at high velocity. These injuries pose significant diagnostic and therapeutic challenges due to their combined mechanical and chemical effects. The case underscores the critical need for resources like intracranial pressure monitoring and advanced neurosurgical care in managing such injuries, especially in conflict zones. The orbito-cranial involvement highlights the vulnerability of the orbital region and its potential to result in fatal outcomes. Conclusion: Orbito-cranial injuries caused by TGCs represent a unique and severe subset of trauma requiring immediate and specialized intervention. This case emphasizes the need for improved safety protocols, systematic injury documentation, and enhanced neurosurgical infrastructure to effectively manage and improve outcome.