{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,27]],"date-time":"2026-05-27T15:56:02Z","timestamp":1779897362690,"version":"3.53.1"},"reference-count":22,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2025,4,30]],"date-time":"2025-04-30T00:00:00Z","timestamp":1745971200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Surg."],"abstract":"<jats:sec><jats:title>Background and importance<\/jats:title><jats:p>Intracranial foreign bodies resulting from criminal assaults that cause penetrating trauma are relatively rare. Such cases are often accompanied by significant complications, including intracranial hemorrhage, cerebral contusion, major vascular injury, and cerebrospinal fluid leakage, which pose substantial challenges in clinical management. Herein, we report a successful case of surgical treatment for an intracranial metallic foreign body, aiming to provide valuable insights for similar clinical scenarios.<\/jats:p><\/jats:sec><jats:sec><jats:title>Clinical presentation<\/jats:title><jats:p>A 38-year-old male patient was urgently admitted to our emergency department following an intentional assault with a sickle, which resulted in an intracranial penetrating injury. Computed tomography (CT) scanning revealed the presence of a metallic foreign body that traversed the left temporal lobe and extended to the sphenoid bone and the posterior region of the right orbit. In response to this critical situation, an emergency surgical procedure was promptly initiated. The treatment strategy involved a combination of craniotomy and transnasal approaches to remove the metallic foreign body and reconstruct the skull base. Postoperatively, the patient exhibited no obvious adverse reactions, and his condition remained stable throughout the follow-up period.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Intracranial foreign bodies often penetrate neural structures via the orbit or nasal cavity. When dealing with a long foreign body predominantly situated within the brain parenchyma, it is crucial to avoid blindly extracting it. Instead, shortening the length of the foreign body may be a more feasible approach to facilitate its safe removal and transportation. Preoperative acquisition of comprehensive imaging data is of utmost importance, as it aids in delineating the spatial relationship between the foreign body, major intracranial vessels, and cranial nerves, thereby enabling the formulation of a rational surgical plan. Whenever possible, the removal of intracranial foreign bodies should be carried out within 6\u20138\u2005h post-trauma. Additionally, reliable skull base reconstruction is essential to prevent cerebrospinal fluid (CSF) leakage and mitigate the risk of infectious complications.<\/jats:p><\/jats:sec>","DOI":"10.3389\/fsurg.2025.1588359","type":"journal-article","created":{"date-parts":[[2025,4,30]],"date-time":"2025-04-30T05:39:47Z","timestamp":1745991587000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":2,"title":["Case Report: an unusual case of a penetrating intracranial metallic foreign body removed via surgery"],"prefix":"10.3389","volume":"12","author":[{"given":"Dang","family":"Tang","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hai","family":"Song","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bibo","family":"Gao","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jiang","family":"Long","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zhongkun","family":"Ren","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2025,4,30]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"1081","DOI":"10.1056\/NEJMc2025923","article-title":"Penetrating injuries from \u201cless lethal\u201d beanbag munitions","volume":"383","author":"Olson","year":"","journal-title":"N Engl J Med"},{"key":"B2","doi-asserted-by":"publisher","first-page":"172","DOI":"10.1055\/s-0038-1642035","article-title":"Penetrating foreign bodies in head and neck trauma: a surgical challenge","volume":"11","author":"Voss","year":"2018","journal-title":"Craniomaxillofac Trauma Reconstr"},{"key":"B3","doi-asserted-by":"publisher","first-page":"2687","DOI":"10.4103\/IJO.IJO_3283_22","article-title":"Bacterial orbital cellulitis\u2014a review","volume":"71","author":"Yadalla","year":"2023","journal-title":"Indian J Ophthalmol"},{"key":"B4","doi-asserted-by":"publisher","first-page":"190","DOI":"10.23736\/S0390-5616.19.04793-3","article-title":"Classification of orbitocranial wooden foreign body penetration injuries: what to do when they violate the intracranial space? A systematic review","volume":"64","author":"Del Verme","year":"2020","journal-title":"J Neurosurg Sci"},{"key":"B5","doi-asserted-by":"publisher","first-page":"734","DOI":"10.1007\/s00347-022-01785-2","article-title":"Diagnostik und Therapie organischer intraorbitaler Fremdk\u00f6rper [Diagnostics and treatment of organic intraorbital foreign bodies]","volume":"120","author":"Holtmann","year":"2023","journal-title":"Ophthalmologie"},{"key":"B6","first-page":"1","article-title":"Wound foreign body removal","volume-title":"StatPearls","author":"Skinner","year":"2025"},{"key":"B7","first-page":"1","article-title":"Foreign body imaging","volume-title":"StatPearls","author":"Campbell","year":"2025"},{"key":"B8","doi-asserted-by":"publisher","first-page":"458","DOI":"10.1016\/s0090-3019(00)00311-6","article-title":"Syringe needle located deep in the brain: image-guided removal","volume":"54","author":"Muhammad","year":"2000","journal-title":"Surg Neurol"},{"key":"B9","doi-asserted-by":"publisher","first-page":"E372","DOI":"10.1227\/NEU.0000000000000691","article-title":"Retained transcranial knife blade with transection of the internal carotid artery treated by staged endovascular and surgical therapy: technical case report","volume":"11","author":"Kodadek","year":"2015","journal-title":"Neurosurgery"},{"key":"B10","doi-asserted-by":"publisher","first-page":"18","DOI":"10.1016\/j.jocn.2007.06.020","article-title":"Penetrating head injury from nailguns: a case series from New Zealand","volume":"15","author":"Winder","year":"2008","journal-title":"J Clin Neurosci"},{"key":"B11","doi-asserted-by":"publisher","first-page":"39","DOI":"10.1186\/s13256-023-04334-w","article-title":"A foreign body that has been left for 20 years causes a pseudoaneurysm of the middle cerebral artery: a case report","volume":"18","author":"Li","year":"2024","journal-title":"J Med Case Rep"},{"key":"B12","doi-asserted-by":"publisher","first-page":"e936463","DOI":"10.12659\/MSM.936463","article-title":"Emergency removal of ingested foreign bodies in 586 adults at a single hospital in China according to the European society of gastrointestinal endoscopy (ESGE) recommendations: a 10-year retrospective study","volume":"28","author":"Liu","year":"2022","journal-title":"Med Sci Monit"},{"key":"B13","doi-asserted-by":"publisher","first-page":"349","DOI":"10.3201\/eid2003.131230","article-title":"Invasive fungal infections after natural disasters","volume":"20","author":"Benedict","year":"2014","journal-title":"Emerg Infect Dis"},{"key":"B14","doi-asserted-by":"publisher","first-page":"487","DOI":"10.1055\/s-0030-1261264","article-title":"Management of a long-standing organic intracranial foreign body","volume":"20","author":"Wieland","year":"2010","journal-title":"Skull Base"},{"key":"B15","doi-asserted-by":"publisher","first-page":"4368","DOI":"10.1039\/C3SM27705D","article-title":"Bacteria-surface interactions","volume":"9","author":"Tuson","year":"2013","journal-title":"Soft Matter"},{"key":"B16","doi-asserted-by":"publisher","first-page":"749","DOI":"10.1016\/j.wneu.2012.06.025","article-title":"Risk factors for intracranial infection secondary to penetrating craniocerebral gunshot wounds in civilian practice","volume":"79","author":"Jimenez","year":"2013","journal-title":"World Neurosurg"},{"key":"B17","doi-asserted-by":"publisher","first-page":"303","DOI":"10.1007\/s00701-022-05432-2","article-title":"Antibiotic prophylaxis in penetrating traumatic brain injury: analysis of a single-center series and systematic review of the literature","volume":"165","author":"Ganga","year":"2023","journal-title":"Acta Neurochir"},{"key":"B18","doi-asserted-by":"publisher","first-page":"e47167","DOI":"10.7759\/cureus.47167","article-title":"Unidentified intracranial foreign body in an epileptic child: infanticide or child abuse?","volume":"15","author":"Ullah","year":"2023","journal-title":"Cureus"},{"key":"B19","doi-asserted-by":"publisher","first-page":"S775","DOI":"10.4103\/2152-7806.193924","article-title":"Cerebral foreign body granuloma in brain triggering generalized seizures without obvious craniocerebral injury: a case report and review of the literature","volume":"7","author":"Brawanski","year":"2016","journal-title":"Surg Neurol Int"},{"key":"B20","first-page":"624","article-title":"Attempted suicide with screw penetration into the cranium","volume":"15","author":"Cemil","year":"2009","journal-title":"Ulus Travma Acil Cerrahi Derg"},{"key":"B21","doi-asserted-by":"publisher","first-page":"8","DOI":"10.4103\/2152-7806.149613","article-title":"Anti-epileptic prophylaxis in traumatic brain injury: a retrospective analysis of patients undergoing craniotomy versus decompressive craniectomy","volume":"6","author":"Ramakrishnan","year":"2015","journal-title":"Surg Neurol Int"},{"key":"B22","doi-asserted-by":"publisher","first-page":"2","DOI":"10.4103\/0972-2327.78041","article-title":"Management of provoked seizure","volume":"14","author":"Misra","year":"2011","journal-title":"Ann Indian Acad Neurol"}],"container-title":["Frontiers in Surgery"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fsurg.2025.1588359\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,4,30]],"date-time":"2025-04-30T05:39:50Z","timestamp":1745991590000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fsurg.2025.1588359\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,4,30]]},"references-count":22,"alternative-id":["10.3389\/fsurg.2025.1588359"],"URL":"https:\/\/doi.org\/10.3389\/fsurg.2025.1588359","relation":{},"ISSN":["2296-875X"],"issn-type":[{"value":"2296-875X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,4,30]]},"article-number":"1588359"}}