Πέμπτη, 21 Φεβρουαρίου 2019

Metallic object penetrated the skin, temporalis muscle, and skull and was embedded in the brain parenchyma

LETTER TO EDITOR
Year : 2019  |  Volume : 14  |  Issue : 1  |  Page : 333

A piece of wire into the brain


Department of Neurosurgery, University Hospital of Ioannina, Ioannina, Greece

Date of Web Publication21-Feb-2019

    

Correspondence Address:
Dr. Andreas Zigouris
Department of Neurosurgery, University Hospital of Ioannina, Ioanninon Avenue, 45500 Ioannina 
Greece
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/ajns.AJNS_46_17

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How to cite this article:
Zigouris A, Konsolakis N, Alexiou G, Voulgaris S. A piece of wire into the brain. Asian J Neurosurg 2019;14:333

How to cite this URL:
Zigouris A, Konsolakis N, Alexiou G, Voulgaris S. A piece of wire into the brain. Asian J Neurosurg [serial online] 2019 [cited 2019 Feb 21];14:333. Available from: http://www.asianjns.org/text.asp?2019/14/1/333/231068



Sir,

A 38-year male presented to the emergency department because of headache and fever over 38°C. From the patient's previous history, it was concluded that he had a small trauma in the right temporal region while he worked with a mowing machine 2 days before the admission. The clinical examination did not reveal any pathological signs while the laboratory examinations showed a leukocytosis and elevated C-reactive protein. Skull X-ray revealed the presence of a foreign body [Figure 1]. Brain computed tomography scan that ensued showed that a foreign metallic object penetrated the skin, temporalis muscle, and skull and was embedded in the brain parenchyma of the right temporal lobe. The patient did not understand what was the object that hit him and he thought that it was a stone.
Figure 1: (a and b) Skull X-ray revealing the presence of a foreign body. (c) Coronal computed tomography. (d) Photograph showing the foreign body

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He was operated under general anesthesia with a temporal craniotomy. In the skin of preauricular area and temporalis muscle, there was a small trauma, when the lepidoid bone had a small point of insertion. After opening the dura, we found a laceration in the right temporal lobe with a perifocal edema (subarachnoid hemorrhage, and contusion). The object was a piece of wire and was removed and also the bone flap because of suspicion of contamination after 2 days with this object into the brain [Figure 1]. The patient received antibiotics (ceftriaxone, metronidazole, and vancomycin) for 6 weeks and made a full recovery.

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