A Rare Case of Chronic Intracerebral Foreign Body


Naufal Hilmy Imran


Introduction: Intracranial foreign bodies are usually caused by trauma that penetrates the cranium. Gunshot wounds are the most common cause, while non-missile intracranial penetration is rare. The patient’s clinical condition highly depends on the mechanism, anatomical location of the lesion, and related injuries. Possible complications include intracerebral hemorrhage, contusion, major injury on the vascular, and meningitis. In this article, we report case of intracerebral nail extraction from a patient with right cerebral foreign body.

Case presentation: A 22-year-old man with a history of unspecified schizophrenia reported with reduced awareness accompanied by weakness of his left limb. During a head CT scan of the head, there are several tubular foreign bodies in the right cerebral. Craniotomy for foreign body extraction and drainage of the cerebral abscess is immediately performed. Four days after surgery, the patient had increased awareness, although there was no significant improvement in motor strength. One month after discharged from hospital there was slight improvement in motor strength.

Conclusion: Extraction of foreign bodies by a surgical procedure is mandatory and should be performed thoroughly. The administration of antibiotics, anticonvulsants, physiotherapy, and psychiatric follow-up should be added to the treatment of this patient.



1. Ali, M., Kumar, A., Hingora, O. M. & Ahmad, F. Sickle Injury to Brain. 23–26 (2015).
2. Gökçek, C. Intracranial Foreing Body. 121–124 (2007).
3. Health, O. Self-inflicted nail-gun injury with 12 cranial penetrations and associated cerebral trauma. 104, 828–834 (2006).
4. Karadas, S., Dursun, R. & Kiymaz, N. CASE REPORT Treatment of intracranial foreign body. 828–829
5. Gopaul, R., Xiao, W. S., Yan, J. & Wei, D. Z. Intracranial foreign body through the sagittal sinus : case report and review of literature. Chinese Neurosurg. J. 1–8 (2016). doi:10.1186/s41016-016-0029-4
6. Reports, C. Ten self-inflicted intracranial penetrating nail gun injuries. 20, 267–270 (2015).
7. Kim, D. H. et al. A Case of Intracranial Wooden Foreign Body : Mimicking Pneumocephalus. 12, 144–147 (2016).
8. Greenberg, M. S. Handbook of Neurosurgery. in 1784 (Thieme, 2019).
9. Allan, T., HR, W. & WM, S. Brain Abscess. in 350–1 (Youmans and Winn Neurological Surgery, 2017).
10. N, W., R, G. & KD, P. Complication Avoidance in Neurosurgery. in 129 (Youmans and Winn Neurological Surgery, 2017).
11. SA, W. et al. Traumatic and Penetrating Head Injuries. in 2922–32 (Youmans and Winn Neurological Surgery, 2017).