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CC BY-NC-ND 4.0 · Asian J Neurosurg 2019; 14(01): 333
DOI: 10.4103/ajns.AJNS_46_17
Letter to Editor

A piece of wire into the brain

Andreas Zigouris
Department of Neurosurgery, University Hospital of Ioannina, Ioannina
,
Nikolaos Konsolakis
Department of Neurosurgery, University Hospital of Ioannina, Ioannina
,
George Alexiou
Department of Neurosurgery, University Hospital of Ioannina, Ioannina
,
Spyridon Voulgaris
Department of Neurosurgery, University Hospital of Ioannina, Ioannina
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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.

Zoom Image
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

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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Publication History

Article published online:
09 September 2022

© 2019. Asian Congress of Neurological Surgeons. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

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