A case of craniocerebral penetrating injury caused by steel rod

CHEN Kui; LI Haichun; LI Yanxin; YAN Wentao; HU Guochao; SHEN Haoyu; YANG Youlei; QIAN Rongjun

doi:10.13798/j.issn.1009-153X.2025.11.013

Abstract：Craniocerebral penetrating injury refers to an open injury that penetrates the skull and brain,involving scalp and facial lacerations,skull fractures,and cerebral contusions.Gunshot wounds are a common cause,while sharp objects such as nails or screwdrivers can also result in rare penetrating injuries.This article reports a rare case of a steel rod penetrating the head.The patient fell from a height while holding a steel rod approximately 1 meter long,which entered from below the right mandible,passed upward and to the left through the oral cavity into the cranial cavity,traversed the oropharynx,and exited at the left frontopa-rietal region.This resulted in blindness in the left eye and significant bleeding from the mouth and nose.Emergency tracheostomy was performed along with fluid resuscitation and other symptomatic treatments.Following multidisciplinary consultation and com-pletion of cranial CT and DSA examinations,the diagnosis was established as cranio-orofacial penetrating injury,left optic nerve in-jury,contusion of the left frontal lobe,and skull fracture.After preoperative preparation,a craniotomy was performed to remove the steel rod,followed by repair of the skull base fistula and cranial reconstruction.Postoperative management included antibiotics and lumbar cisternal drainage for infection prevention/control.Over one month after surgery,the patient recovered well and resumed normal life.A six-month telephone follow-up indicated persistent blindness in the left eye,with no symptoms such as headache,dizziness,or limb weakness.In summary,for patients with complex craniocerebral injuries,formulating a comprehensive treatment plan through multidisciplinary consultation is crucial to reduce improper maneuvers and iatrogenic injuries.