case_images: PMC10676273_01
case_images: Preoperative image showing the rake embedded in the parietal regions.
case_images: CRINM2023-9921985.001.jpg
case_images: PMC10676273_01_CRINM2023-9921985.001.jpg
case_images: fig1
case_images: A 5-year-old boy was admitted with a rake embedded in the head (Figure 1).
case_images: Bone window head CT scan in coronal section showing 2 hyperdensities from either side the midline with metal artifact.
case_images: CRINM2023-9921985.002.jpg
case_images: PMC10676273_01_CRINM2023-9921985.002.jpg
case_images: fig2
case_images: The head CT scan performed showed parietal hyperdensity from either side of the midline with metal artifact (Figures 2 and 3).
case_images: Parenchymal window head CT scan in coronal section showing 2 hyperdensities from either side the midline with metal artifact.
case_images: CRINM2023-9921985.003.jpg
case_images: PMC10676273_01_CRINM2023-9921985.003.jpg
case_images: fig3
case_images: The head CT scan performed showed parietal hyperdensity from either side of the midline with metal artifact (Figures 2 and 3).
case_images: Intraoperative image showing the bone flap centered on the 2 penetrating points of the 2 tips of the rake; the bony filing at the base of the 2 penetrating tips is visible.
case_images: CRINM2023-9921985.004.jpg
case_images: PMC10676273_01_CRINM2023-9921985.004.jpg
case_images: fig4
case_images: A bone flap was performed followed by a bony filing at the base of the 2 tips (Figure 4).
case_images: The extracted rake.
case_images: CRINM2023-9921985.005.jpg
case_images: PMC10676273_01_CRINM2023-9921985.005.jpg
case_images: fig5
case_images: And then, we proceeded with the bone flap extraction together with the two tips of the rake (Figure 5).
case_images: Intraoperative image showing the 2 dural breaches corresponding to the 2 entry points of the 2 tips.
case_images: CRINM2023-9921985.006.jpg
case_images: PMC10676273_01_CRINM2023-9921985.006.jpg
case_images: fig6
case_images: That allowed us to discover 2 punctiform breaches on the dura mater at the penetrating points of the rake (Figure 6).
case_images: Intraoperative image taken after duraplasty.
case_images: CRINM2023-9921985.007.jpg
case_images: PMC10676273_01_CRINM2023-9921985.007.jpg
case_images: fig7
case_images: Then, wound debridement was performed followed by duraplasty using two pieces of galea that we fixed over each dura breach with a 4-0 prolene (Figure 7); then we tented the dura, replaced, and fixed the bone flap; and finally we performed a layer and layer closing of the subcutaneous and cutaneous tissues followed by a bandage.