A 67 year old alcoholised woman stumbled over an unevenness, lost her balance, and fell into an ordinary butterknife while preparing cat food.

Initially the woman was awake with a Glasgow coma scale (GCS) of 9. On hospital admission, she was intubated, sedated, the pupils were equal and reactive to light, the eyeballs were both intact, and there was no neurological deficit. The handle of the knife was protruding from the right orbit. There was a leakage of bloody cerebrospinal fluid (CSF) out of the inner right canthus.

X ray …