A 34-year-old man was admitted to the emergency room after being stabbed in the left temporal area with his nervous system intact. CT of the head showed that the knife had penetrated the left temporal bone, the left sphenoid, the left pterygopalatine fossa, and the left

A 34-year-old man is admitted to the emergency department after being stabbed in the left temporal area with his nervous system intact. CT of the head shows that the knife has penetrated the left temporal bone, left sphenoid, left pterygopalatine fossa, and left maxillary sinus.

Computed tomography angiography (CTA) shows no significant vascular damage, but is less accurate due to streak artifacts. The surgery makes a small incision around the knife to advance the endoscope into the maxillary sinus and immediately sees the knife.

Under direct vision, the knife is removed with little bleeding. Again DSA showed distal and proximal middle meningeal artery injury in the left internal maxillary artery, and embolization was performed to stop bleeding.