Asymptomatic Intracranial Foreign Body: An Incidental Finding on Radiography

Abstract

IntroductionIntracranial needles are rare entities. Intracranial foreign bodies due to non-missile intracranial penetrations are one of the most rarely encountered situations in neurosurgery. Sewing needles are among the more unusual foreign bodies that may be found in the brain. Although uncommon, foreign body cases are important and interesting. Foreign bodies enter the body through trauma or iatrogenic injuries. Needles are mostly inserted through fontanelles, cranial sutures, and more rarely through the orbits in infancy for the purpose of killing unwanted babies.Case PresentationThis article presents a case of intracranial foreign body found upon radiography. A 24-year-old female, who two days prior to presentation suffered only once from dizziness, and was otherwise healthy.ConclusionsBecause this incident may have occurred during the patient’s neonatal period, it may be a case of child abuse. In spite of the very limited number of cases in the literature, having a stepmother, a stepfather, or a babysitter, being the youngest child, or having family members who suffer from psychiatric disorders, (especially if these relatives are responsible for child care), living in a society that allows homicide of children born from extramarital relationships, and being female have been suggested as possible risk factors.

Surgical removal of a sewing needle penetrated through the foramen lacerum into a canine brain

“…In human medicine, intracranial foreign bodies can be secondary to traumatic brain injuries, shotgun wounds, industrial accidents, suicide attempts and self-inflicted wounds (Gokcek et al 2007, Kazim et al 2011, Zyck et al 2016. Sewing needles are among the least common foreign bodies; they have been described as related to attempted murders in infancy before closure of fontanelles (Sturiale et al 2010;Maghsoudi et al 2016) and are incidental findings at necropsy or following diagnostics for head injuries, headaches or epilepsy (Abbassioun et al 1979;Pelin & Kaner 2012).…”

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.…”

Intracerebral foreign body: A needle in a dog's brain

“…Cognitive decline, fever, brain abscess, meningitis occur only occasionally, and almost one-third of them are asymptomatic. 5 Transcranial sewing needle penetration through the fontanelle sometimes occurs as a homicide attempt (often related to cultural background). [5][6][7][8] Until 2010, 40 case reports were published about suspected sewing needle insertion through the fontanelle.…”

“…5 Transcranial sewing needle penetration through the fontanelle sometimes occurs as a homicide attempt (often related to cultural background). [5][6][7][8] Until 2010, 40 case reports were published about suspected sewing needle insertion through the fontanelle. 6 Most of them were clinically asymptomatic and rarely presented with seizure, headache or altered behaviour.…”

“…6 Most of them were clinically asymptomatic and rarely presented with seizure, headache or altered behaviour. 5,9 Many case reports have been published where the needle penetration occurred in infant years, but caused clinical symptoms only years later, in their adult life. In most of these cases, no surgeries were required due to the risk of surgery.…”