• Seckin Aydin.
• Department of Neurosurgery, University of Health Sciences, Okmeydani Training and Research Hospital, Istanbul, Turkey. Electronic address: seckin047@hotmail.com.
• World Neurosurg. 2019 Sep 1; 129: 237-240.

BackgroundIntracranial penetrating traumas (IPTs) are rarely encountered in neurosurgery practice. Here, we report the case of a patient with orbital and cranial trauma caused by an unexpected object.Case DescriptionA 37-year-old male presenting with a right orbital penetrating injury was referred to our emergency department. Neurologic examination of the patient revealed right periorbital ecchymosis, a dilated and fixed right pupil, and right hemiparesis. Cranial computed tomography showed fractures of the right orbital medial wall and the anterior skull base, as well as bifrontal and left parietal intracerebral hemorrhage accompanied by a metallic foreign body artifact. Emergency left frontoparietal decompressive craniectomy was performed, and the foreign body, identified as a fishing sinker, was removed. No additional postoperative complications were observed, and cranioplasty was performed 6 months postoperatively.ConclusionsIPTs have high morbidity and mortality rates. Early surgical intervention is often the first treatment option. Intracranial injury caused by a fishing sinker is an extremely rare low-energy intracranial penetrating trauma, and in the literature, this is the first reported case in which the patient survived.Copyright © 2019 Elsevier Inc. All rights reserved.

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