139 ©Copyright 2022 Ankara University Faculty of Medicine Journal of Ankara University Faculty of Medicine is published by Galenos Publishing House. All content are under CC BY-NC-ND license. An Intracranial Foreign Body That Encountered Incidentally After Years Yıllar Sonra Tesadüfen Karşılaşılan İntrakraniyal Bir Yabancı Cisim Ankara Üniversitesi Tıp Fakültesi Mecmuası 2022;75(1):139-141 Koral Erdoğan, Anıl Eray, İhsan Doğan Ankara University Faculty of Medicine, Department of Neurosurgery, Ankara, Turkey CASE REPORT / OLGU SUNUMU SURGICAL SCIENCES / CERRAHİ TIP BİLİMLERİ Erdoğan et al. An Intracranial Foreign Body That Encountered Incidentally After Years Abstract Intracranial penetrating foreign bodies are one of the most rarely encountered situations in neurosurgery practice. Although they are uncommon, intracranial foreign bodies are potentially fatal entities. Sewing needles in the brain are among the more unusual foreign bodies. In this article, we presented a case with a sewing needle in the cranium that was detected incidentally. There were no clinical symptoms or inflammatory findings in the insertion area and no external sign of the puncture. We document this patient to highlight the management of such cases with the goal to improve outcome and minimize short and long term complications. Key Words: Penetrating Head Injuries, Sewing Needle, Intracranial Foreign Bodies Öz Kafa içi penetran yabancı cisimler, nöroşirürji pratiğinde en nadir karşılaşılan durumlardan biridir. Nadir olmalarına rağmen, kafa içi yabancı cisimler potansiyel olarak ölümcül antitelerdir. Beyindeki dikiş iğneleri daha sıra dışı yabancı cisimler arasındadır. Bu yazıda kafatasında tesadüfen dikiş iğnesi saptanan bir olguyu sunuyoruz. Hiçbir klinik semptom veya giriş alanında enflamatuvar bulgu yoktu ve giriş deliğine ait bir belirti yoktu. Bu hastayı bu tür olguların yönetimini vurgulamak, daha iyi sonuçlar elde etmek ve kısa veya uzun vadeli komplikasyonları en aza indirmek amacıyla dokümante ediyoruz. Anahtar Kelimeler: Penetran Kafa Yaralanmaları, Dikiş İğnesi, İntrakraniyal Yabancı Cisimler Introduction Penetrating head injuries are commonly associated with a poor neurological prognosis and have a high risk of mortality, accounting for only 0.4% of all head injuries (1). They are rarely encountered in neurosurgery. Most of them result from work-related accidents, motor vehicle accidents, falls, criminal assaults or suicide. Foreign bodies mostly penetrate the cranium through the orbita, frontal sinus, ear and nasal regions. Although they are less common than closed head traumas, massive penetrating head injuries are major causes of death and severe disability as a result of intracerebral hematoma, cerebral contusion, intraventricular hemorrhage, pneumocephalus, caroticocavernous sinus fistula, vascular disruption or meningitis. The rate of vascular complications due to penetrating cerebral injuries ranges from 5% to 40% in the literature (2). Early recognition of these injuries is important to achieve the best possible outcome. Generally based on the impact velocity they can be grouped into two categories: high and low velocity penetrations. Intracranial needles were first documented by Meixner (3) in 1914, in two children. In infancy, needles in cranium are usually inserted through fontanelles or cranial sutures and more rarely orbita, ears or nose for the purpose of infanticide (4). Insertion of needles through the fontanel is mostly seen as an attempt for child abuse. Although most of the cases reported in the related literature were diagnosed incidentally, patients may present late in life with epilepsy or headache. Very few symptomatic patients are encountered in articles previously published. The most common symptoms are headache and epilepsy (5). Delayed Address for Correspondence/Yazışma Adresi: Koral Erdoğan Ankara University Faculty of Medicine, Department of Neurosurgery, Ankara, Turkey Phone: +90 543 977 98 87 E-mail: koralerdogan@gmail.com ORCID ID: orcid.org/0000-0002-5335-7172 Received/Geliş Tarihi: 11.06.2021 Accepted/Kabul Tarihi: 27.08.2021 DOI: 10.4274/atfm.galenos.2021.65668