case_images: PMC5899847_01
case_images: Photograph of a metal bar that had penetrated the right parietal region.
case_images: CRIEM2018-3025717.001.jpg
case_images: PMC5899847_01_CRIEM2018-3025717.001.jpg
case_images: fig1
case_images: A 29-year-old man whose head was impaled with a metal bar was transferred to our hospital by ambulance (Figure 1).
case_images: (a) Plain X-ray of the skull (A-P view) showing a hook-shaped metal bar on the right side. (b) Plain X-ray of the skull (R-L view) showing the metal bar in the frontal region.
case_images: CRIEM2018-3025717.002.jpg
case_images: PMC5899847_01_CRIEM2018-3025717.002.jpg
case_images: fig2
case_images: Skull X-ray showed a 10 mm wide metal bar inserted into the right frontal region of the head at a depth of >100 mm (Figures 2(a) and 2(b)).
case_images: Axial computed tomography of the head (bone window), showing the intracranial penetration of a hook-shaped metal bar measuring 50.8 mm x 46.2 mm.
case_images: CRIEM2018-3025717.003.jpg
case_images: PMC5899847_01_CRIEM2018-3025717.003.jpg
case_images: fig3
case_images: CT of the head showed a hook-shaped metal bar measuring 51 mm x 46 mm in the right frontal lobe via the frontal bone (Figure 3). Cerebral CT angiography showed no apparent major vessel injury-related complication.
case_images: Intraoperative photographs. (a) Exposure of the metal bar after a semicircular incision. (b) The hook-shaped metal bar is shown to penetrate the frontal lobe without causing injuries to major arteries. (c) Neither bleeding nor hematoma was observed after removal. (d) The metal bar after surgical removal.
case_images: CRIEM2018-3025717.004.jpg
case_images: PMC5899847_01_CRIEM2018-3025717.004.jpg
case_images: fig4
case_images: A-horse-shoe flap was created around the metal bar (Figure 4(a)), and the bone fixed under the foreign body was removed to prevent unnecessary movement. No major vessel injury or hematoma formation was observed intraoperatively, and the foreign body was removed under direct visualization (Figures 4(b), 4(c), and 4(d)).