Intracranial sewing needle in a dog

The objective of this clinical case study is to describe the first clinical case of an intracranial sewing needle identified in veterinary medicine and to describe the second case of intracranial foreign body secondary to pharyngeal perforation. A one-year-old Maltese dog with acute haemorrhagical vomiting and seizure was evaluated. A cerebral CT scan revealed the presence of a sewing needle inserted into the nasopharynx, which perforated the caudal cranial fossa through the brainstem, cerebellum and caudal part of the forebrain. An emergency surgery was performed, the needle was removed and the dog recovered well during the following 72 hours. One month after the surgery, the dog was still fine. This clinical case reinforces the possibility of cranial perforation after sharp foreign body ingestion. Intracranial foreign body should be part of the differential diagnosis in dogs when acute digestive signs are associated with acute neurological complications.

An unsuspected intracranial foreign body on the acute medical unit

A 54-year-old man was referred to the acute medical unit with a suspected stroke after presenting to his general practitioner with altered speech, left sided facial droop and confusion. The patient had a new right sided swelling on the lateral aspect of his head but did not report any history of trauma. Imaging revealed a 9.2 cm nail entering via the right parietal bone with associated acute haemorrhage. After further discussion with the patient, he disclosed a suicide attempt with a nail gun 5 days prior to presentation. The nail was successfully removed by the neurosurgical team and the patient received rehabilitation and psychiatric assessment on the brain injury unit before going home.

Intracranial foreign body in a child

Intracranial foreign bodies are rare events that occur accidentally and depending on the extent and involvement of the brain parenchymal, generate focal neurological deficit, bleeding and even long-term complications. In present article we describe a case of 4 year child and discuss the approach, management and prognosis.