Drill bit breakage with tip dislodgment deep into the brain parenchyma: A unique craniotomy complicatıon.

Background:

Breakage of the drill bit during craniotomies is quite common; however, penetration of the dura and leptomeningeal layers and dislodging of the broken fragment into the brain parenchyma have not been previously reported.

Case description:

This case report demonstrates a unique and challenging complication in neurosurgery involving a 57-year-old male patient who presented with a large hypertensive intracerebral hemorrhage in the right hemisphere, and intractable intracranial hypertension was taken to the operating room to perform a right decompressive craniectomy and evacuation of intraparenchymal hematoma. During the craniotomy using a disposable, footed B1 drill bit, the drill bit broke and was not found during the surgery. Following the surgical procedure, the routine postoperative computed tomography scan revealed a dislodged drill bit fragment deeply embedded within the frontal lobe parenchyma. The patient was taken again to the operating room. Under fluoroscopy guidance, the drill bit was extracted successfully.

Conclusion:

We present this unique case as it can be encountered in daily neurosurgical practice and present our recommendations for management and prevention of such a rare complication, which can be helpful to other neurosurgeons.