Unexpected Intracranial Metallic Foreign Body in Child: Case Reports in Non-War Area and Literature Review

Abstract

Introduction: The occurrence of an intracranial metallic foreign body in children is often due to home accidents, child abuse or wars. Our aim was to highlight more this phenomenon quite rare, becoming from nowadays of public health and to compare adapted treatments to originator ones of the Literature. Two children with both brain injury due to metal after domestic accident, operated in 2018 and closely followed-up during 3 years were gathered. Their cases are reported, and their features discussed according to Literature. Cases presentation: Children were 13-month-old and 12-year-old all operated less than 24 hours after the trauma. It was a masonry nail long of 5 centimetres (cm) for the infant and ᴓ8 (millimetres = mm) iron rod long of 48 cm for the teenager. The mechanism was the fall at home from his height or from a mangoes-tree. The entry zone was the left-occipital in the first case and the right inner canthus in the second. The metallic foreign body was surgically removed in both cases and without complications. The follow-up during 3 and half years was also neurologically uneventful. Discussion/conclusion: Metallic intracranial foreign bodies are encountered mostly in wartime or high violence area, rarely in domestic games. None Angio-CT-scan was performed. Surgical removal must be as earlier when possible but should not omit a prior radio-clinic exploration with better anatomical radio-analysis (on the CT-scan). The spectacular appearance of non-missile penetrating head injuries incites a rapid surgery in order to limit complications, particularly infectious ones.