Successful removal of an impacted metallic arrowhead penetrating up to the brainstem

Abstract

A case of impacted metallic arrowhead in the brain through an unusual route of the neck and behind the external carotid artery to the base of the skull up to the brainstem is reported. Review of the literature reveals no previous reports of this type of injury. A 35-year-old man was admitted to the hospital after 36 h of injury, being fully conscious and with partial facial palsy. The arrowhead was successfully removed by exploration of the entry wound, without any neurovascular complications. The patient not only survived the operation but was also discharged in an improved neurological condition.

Craniocerebral arrow injury with survival

“…Delayed CSF leak from the skull base lesion was evident once the brain edema subsided 4 . Such nonfatal transcranial penetrating arrow injuries, though rare has been described previously 5 .…”

Arrowhead Injury of Central Nervous System: Three Rare Cases from Rural India

“…1,4 However, those involving the CNS are fairly uncommon, although a few cases have been reported. [5][6][7] The mechanism of injury caused by fired arrow is similar to injuries caused by low-velocity missiles. Arrows have a considerable penetrating capacity in soft tissue and flat bones.…”

Treatment of Arrow Wounds: A Review

“…At the turn of the 20th century, the occurrence of arrowhead injuries declined, and with it, so too did the literature concerning their management [ 2 - 3 ]. Recently, however, there has been a resurgence of documented cases concerning the difficulty in managing such traumatic injuries [ 3 ].…”

“…At the turn of the 20th century, the occurrence of arrowhead injuries declined, and with it, so too did the literature concerning their management [ 2 - 3 ]. Recently, however, there has been a resurgence of documented cases concerning the difficulty in managing such traumatic injuries [ 3 ]. In 2010, a case report was published by Paramhans et al describing a 35-year old male who presented with an impacted metallic arrowhead in his brainstem [ 3 ].…”

“…Recently, however, there has been a resurgence of documented cases concerning the difficulty in managing such traumatic injuries [ 3 ]. In 2010, a case report was published by Paramhans et al describing a 35-year old male who presented with an impacted metallic arrowhead in his brainstem [ 3 ]. Their report concluded with an improvement of the patient’s neurological deficits after removal of the arrowhead.…”