Case Report

A Metallic Skewer Penetrating the Skull

Abstract

A 35-year-old man was admitted to the emergency department complaining of skewer penetration into his head. He had stable hemodynamics and intact neurological examinations upon admission. The imaging evaluation by computed tomography (CT) showed a metallic skewer penetrated into the left temporal associated with a subdural bleeding, contusion, and depressed bone fracture. In an emergency operation, the pterional approach was implemented, and the skewer was extracted. After six months follow-up, the patient had an intact neurological outcomes and CT angiography demonstrated no vascular complications. The metallic skewer penetration into the brain as a low-velocity penetrant can be safely managed by the implementation of imaging studies, prophylactic drug prescriptions, and planned surgical interventions

1. Joseph B, Aziz H, Pandit V, et al. Improving survival rates after civilian gunshot wounds to the brain. J Am Coll Surg 2014;218:58-65.
2. Karger B. Penetrating gunshots to the head and lack of immediate incapacitation. II. Review of case reports. Int J Legal Med 1995;108:117-26.
3. Marhold F, Scheichel F, Ladisich B, et al. Surviving the Scene in Civilian Penetrating Brain Injury: Injury Type, Cause and Outcome in a Consecutive Patient Series in Austria. Front Surg 2022;9:923949.
4. Aghabiklooei A, Molahoseini R, Khajoo A, Shiva H. Multiple nails in the brain: an unusual suicidal attempt. Am J Forensic Med Pathol 2012;33:88-9.
5. Vakil MT, Singh AK. A review of penetrating brain trauma: epidemiology, pathophysiology, imaging assessment, complications, and treatment. Emerg Radiol 2017;24:301-309.
6. BouHaidar R, Lunyova ZM. A screwdriver in the skull. Forensic Sci Med Pathol 2005;1:61-63.
7. Cvetković D, Živković V, Damjanjuk I, Nikolić S. “The pen is mightier than the sword” – suicidal trans-orbital intracranial penetrating injury from a pencil. Forensic Sci Med Pathol 2018;14:221-224.
8. Shaukat S, Zaidi SMF, Khatri A, et al. Self-inflicted penetrating brain injuries with preserved neurological function: a case series. Chin Neurosurg J 2023;9:15.
9. Lee YC, Kwan HH, Wong T, Pan NY, Lai HY, Ma KF. Self-inflicted transorbital brain injury by chopsticks in a patient with acute psychosis. Hong Kong Med J 2017;23:313-4.
10. Zima LA, Srinivasan S, Budde B, Kitagawa R. Thirty-two nails injected into the head: An operative report and review of the literature. Surg Neurol Int 2022;13:377.
11. Bayston R, de Louvois J, Brown EM, Johnston RA, Lees P, Pople IK. Use of antibiotics in penetrating craniocerebral injuries. “Infection in Neurosurgery” Working Party of British Society for Antimicrobial Chemotherapy. Lancet 2000;355:1813-7.
12. Cook R, Zima L, Khazaal J, Williams J. Low-velocity penetrating brain injury: a review of the literature and illustrative case. Brain Inj 2024;38:668-674.
Files
IssueVol 64 No 2 (2026) QRcode
SectionCase Report(s)
DOI https://doi.org/10.18502/acta.v64i2.21536
Keywords
Brain trauma Penetrating brain injury Skull Foreign body
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Creative Commons License This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
How to Cite
1.
Mansouri A, Rezaei Y. A Metallic Skewer Penetrating the Skull. Acta Med Iran. 2026;64(2):98-101.