• Koshi Ota, Hitoshi Kobata, Shunsuke Tomonishi, Kanna Ota, and Akira Takasu.
• Department of Emergency and Critical Care Medicine, Osaka Medical and Pharmaceutical University, Takatsuki City, Osaka, Japan.
• Medicine (Baltimore). 2024 May 3; 103 (18): e37896e37896.

RationaleLow-velocity penetrating head injury (PHI) is rare, comprising 0.2% to 0.4% of head traumas, but can be devastating and is associated with significant morbidity and mortality. No previous case of very-low-velocity PHI due to self-inflicted stabbing with a gimlet has been reported.Patient ConcernsA 62-year-old man was admitted to the hospital with bleeding head and abdominal wounds after stabbing his abdomen with a gimlet, and then hammering the same gimlet into his forehead and removing the gimlet himself.DiagnosesUpon examination at admission, stab wounds were present on the forehead and the right upper quadrant. Computed tomography (CT) of the head revealed a bone defect in the left frontal bone and showed the intracranial path of the gimlet surrounded by mild hemorrhage and pneumocephalus. Magnetic resonance imaging (MRI) confirmed a small amount of hemorrhage with pneumocephalus but no vascular injury.InterventionsConservative treatment without surgery.OutcomesFollow-up MRI on hospital day 58 showed no abscess or traumatic intracranial aneurysm. The patient achieved full recovery of motor and mental functions with conservative treatment and was discharged on hospital day 69.LessonsVery-low-velocity PHI might be successfully treated with conservative treatment.Copyright © 2024 the Author(s). Published by Wolters Kluwer Health, Inc.

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