“Mosaic Pattern” Foreign Bodies in Computed Tomography of the Head: A Specific Sign to Detect Tempered Glass-Related Head Injury

Abstract

A 40-year-old male patient presented to us with a history of road traffic accident, followed by loss of consciousness and vomiting. Noncontrast computed tomography (NCCT) scan revealed frontal bone defect along with multiple “mosaic pattern” homogenously hyperdense foreign bodies of nearly similar size in the right frontoparietal region within the extradural space. Debridement craniectomy was done, and multiple pieces of glass were retrieved. The extremely unique radiologic finding and probably first in the English literature prompted us to report this interesting case. Unfortunately, the patient died of myocardial infarction 3 days after the injury. Further, this new “mosaic pattern” radiologic finding on NCCT of the head may help in determining the mechanism of injury due to tempered glass-related head trauma. Window glass may not be always safe as it is thought by commuters.

Glass Penetrating Skull Injury Mimicking Projectile Injury

“…Numerous types of foreign bodies, such as wood, pellets, stones, umbrella tips, pencils, nails, keys, and knitting needles, have been reported in the literature. 1 A case of penetrating head injury caused by glass was reported by Gray et al 2 Rarely does glass cause such an injury. The potential for misdiagnosis of this type of injury has been discussed in the literature.…”

“…Most of the intracranial foreign bodies occur around the orbit, frontal sinus, and the nasal areas because of the thinness of bone at such places. Numerous types of foreign bodies, such as wood, pellets, stones, umbrella tips, pencils, nails, keys, and knitting needles, have been reported in the literature 1 …”