Tehran University of Medical Sciences Acta Medica Iranica 0044-6025 64 2 2026 05 19 98 101 Arash Mansouri Department of Neurosurgery, Vali-e-Asr Hospital, Meshgin Shahr, Iran . AND Medical School, Ardabil University of Medical Sciences, Ardabil, Iran . Yousef Rezaei Medical School, Ardabil University of Medical Sciences, Ardabil, Iran. AND Heart Valve Disease Research Center, Rajaie Cardiovascular Institute, Iran University of Medical Sciences, Tehran, Iran. AND Behyan Clinic, Pardis New-Town, Tehran, Iran 2024 11 13 2025 07 20 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 https://acta.tums.ac.ir/index.php/acta/article/view/11356 https://acta.tums.ac.ir/index.php/acta/article/download/11356/6034