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DOI: 10.4103/ajns.AJNS_46_17
A piece of wire into the brain
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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.
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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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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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References
- 1 Boström A, von Lehe M, Hartmann W, Pietsch T, Feuss M, Boström JP, et al. Surgery for spinal cord ependymomas: Outcome and prognostic factors. Neurosurgery 2011;68:302-8.
- 2 Wu L, Yang T, Deng X, Yang C, Zhao L, Fang J, et al. Surgical outcomes in spinal cord subependymomas: An institutional experience. J Neurooncol 2014;116:99-106.
- 3 Krishnan SS, Panigrahi M, Pendyala S, Rao SI, Varma DR. Cervical subependymoma: A rare case report with possible histogenesis. J Neurosci Rural Pract 2012;3:366-9.
- 4 Zenmyo M, Ishido Y, Terahara M, Yamamoto T, Tanimoto A, Komiya S, et al. Intramedullary subependymoma of the cervical spinal cord: A case report with immunohistochemical study. Int J Neurosci 2010;120:676-9.
- 5 Pluchino F, Lodrini S, Lasio G, Allegranza A. Complete removal of holocord subependymoma. Case report. Acta Neurochir (Wien) 1984;73:243-50.
- 6 Wiestler OD, Schiffer D. Subependymoma. In: Kleihues P, Cavenee WK, editors. Pathology and Genetics of Tumours of the Nervous System. Lyon, France: IARC; 2000. p. 80-1.
- 7 Scheithauer BW. Symptomatic subependymoma. Report of 21 cases with review of the literature. J Neurosurg 1978;49:689-96.
- 8 Jabri HE, Dababo MA, Alkhani AM. Subependymoma of the spine. Neurosciences (Riyadh) 2010;15:126-8.
- 9 Fu YS, Chen AT, Kay S, Young H. Is subependymoma (subependymal glomerate astrocytoma) an astrocytoma or ependymoma? A comparative ultrastructural and tissue culture study. Cancer 1974;34:1992-2008.
- 10 Moss TH. Observations on the nature of subependymoma: An electron microscopic study. Neuropathol Appl Neurobiol 1984;10:63-75.
- 11 Nagashima M, Isu T, Iwasaki Y, Miyamachi K, Akino M, Abe H, et al. Intramedullary subependymoma of the cervical spinal cord. Case report. Neurol Med Chir (Tokyo) 1988;28:303-8.
- 12 Ho KL. Concurrence of subependymoma and heterotopic leptomeningeal neuroglial tissue. Arch Pathol Lab Med 1983;107:136-40.
- 13 Toi H, Ogawa Y, Kinoshita K, Hirai S, Takai H, Hara K, et al. Bamboo leaf sign as a sensitive magnetic resonance imaging finding in spinal subependymoma: Case report and literature review. Case Rep Neurol Med 2016;2016:9108641.
- 14 Dario A, Fachinetti P, Cerati M, Dorizzi A. Subependymoma of the spinal cord: Case report and review of the literature. J Clin Neurosci 2001;8:48-50.
- 15 Wu Z, Iwanami A, Yasuda A, Mikami S, Toyama Y, Nakamura M. Intramedullary cervicothoracic subependymoma: Report of three cases and review of the literature. J Orthop Sci 2015;20:927-34.