A Rare History: an Intracranial Nail Present for Over a Half-Century

Abstract

We present a rare case of a patient with a persistent headache for many years found to have an intracranial nail present for nearly 65 years. The nail was found entering approximately 1 cm from the midline on the left side, passing below the superior sagittal sinus, with the tip 1.5 mm right of the frontal horn of the lateral ventricle. Treatment strategies designed to optimize outcome for intracranial foreign bodies and possible complications are discussed in this report. We also discuss the decision for surgical intervention for foreign bodies and the relevance of position of the foreign body.

An unsuspected intracranial foreign body on the acute medical unit

“…Intracranial foreign bodies are infrequently encountered and reports in the literature suggest that such events are usually associated with deliberate self-harm and suicide,1–3 criminal assault,2 industrial accident2 and suspected child abuse or infanticide attempts 4 5. The presence of an intracranial foreign body may not be initially suspected by patients and doctors due to an absence or limited number of symptoms, which may delay presentation to medical services and identification of the foreign body 6 7. Mental health issues such as depression affect a huge proportion of adults and episodes of self-harm in men have increased since 2007 8.…”

Fencing unmasked: A case of penetrating cranio-orbital injury

“…Our patient presented with nothing more than an innocuous eyelid laceration. In some cases, a retained foreign body may present as epilepsy or headache even years after the initial event 8 . Early recognition of occult intracranial injury is pivotal to provide prompt treatment.…”