Cranial impalement : a late discovery of a non-metal foreign object
No Thumbnail Available
Meeting name
Sponsors
Date
Journal Title
Format
Article
Abstract
A 64-year-old farmer was brought to the emergency department after he was found lying on the ground. He had been herding sheep in the fields prior to being found. He was disoriented, and left facial edema was seen, as well as a small laceration on the left side of his upper lip and hematic traces in the oral cavity. Head computed tomography (CT) revealed a 122- Hounsfield-unit (HU) linear foreign body that penetrated the base of the skull (Figure 1). Seven days later, a new CT scan revealed an increase in density (137 HU) of the penetrating body (Figure 2). Infectious complications developed, and despite antibiotic therapy, progressed to septic shock and death. The material of the penetrating foreign body was never identified. Detection of head-penetrating foreign bodies remains a challenge, mainly because they may not be visible on clinical examination, and some materials, like wood, are barely visible on CT scans. Wooden foreign bodies demonstrate increasing HU over time (within approximately one week), probably caused by the gradual absorption of blood and liquid into porous dry wood. We hypothesize that the farmer had a wooden walking stick with a sharpened tip. Somehow, he tripped and as he fell, he got stabbed with the cane in the face, penetrating the base of the skull. The impact caused the tip of the cane to break off. As soft tissue swelled, the remains of the cane became embedded in the soft tissue, leaving no trace of the foreign body on clinical examination.
Table of Contents
DOI
PubMed ID
Degree
Thesis Department
Rights
OpenAccess.
License
This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivs 3.0 License.