Sewing needles in the brain: infanticide attempts or accidental insertion?

A case of MRI-induced headache caused by an intracranial foreign body

This case report delves into a unique occurrence of MRI-induced headaches attributed to an unsuspected intracranial foreign body. A male patient, presenting persistent headaches, experienced exacerbation of pain upon entering the MRI suite, hindering the imaging procedure. A subsequent head CT scan revealed a nail within the cranial cavity, stemming from a previous nail gun injury. Surgical removal was deemed unsafe, leading to continued observation. This case emphasizes the need for cautious exploration of abnormal symptoms in the MRI suite, urging healthcare professionals to consider potential foreign bodies. The incident underscores the risk of metallic fragments causing complications during MRI procedures and highlights the importance of thorough patient assessment before resorting to MRI imaging.

Repetitive Self-Inflicted Craniocerebral Injury in a Patient with Antisocial Personality Disorder

Self-inflicted penetrating injuries in patients with mental disorders are a rare phenomenon. The authors report the case of a prisoner who recurrently presented to the emergency department over a period of four years for self-insertion of six metal foreign bodies into the skull. Computed tomography each time revealed the presence of a metal foreign body (screw, nail, metal rod, and wire) passing through the frontal bone into the frontal lobe. In each situation, the foreign body was safely extracted with a favorable outcome. Despite the use of the latest imaging modalities, metal artifacts can limit the assessment of vascular involvement, and special attention must be given to preoperative planning. Surgical extraction of the foreign body can be safely performed when appropriate preoperative planning is carried out to consider all possible complications.

Surgical removal of a sewing needle penetrated through the foramen lacerum into a canine brain

An intracranial metallic foreign body (sewing needle) was diagnosed in an 11-month-old Cavalier King Charles Spaniel. Clinical evaluation showed drooling and chewing, but an otherwise normal neurological examination. Skull radiographs showed a metallic foreign body extending from the pharynx into the skull. A CT scan confirmed the presence of a foreign body crossing the right foramen lacerum into the brain. The needle was removed surgically with the aid of fluoroscopy.

Intracranial sewing needle - accidentally inserted from a traditional cap worn by infants

Patients with intracranial needles have rarely been reported. Several foreign bodies penetrating the cranium such as knives, nails, pencils, and wood pieces have been described in the literature. It is rare to discover a foreign body which has been inserted through either of the fontanelles before their closure in an attempted infanticide. Here we report one such rare case of intracranial sewing needle in a 24-year-old female which was accidentally inserted through the open anterior fontanelle from the traditional skull cap she was wearing during infancy. The needle was discovered incidentally on a routine skull radiograph done for a minor head injury. It was decided against any intervention to remove the needle owing to the fact that the presence of the foreign object was not causing any symptoms.

A late onset adult seizure due to intracerebral needle: case-based update

BACKGROUND AND AIM

Late-onset seizure due to intracerebral needle is a rare entity. Most of them were clinically asymptomatic and rarely presented with seizure. Sewing needles are used in homicidal attempt in infancy or early childhood before the closure of the fontanels. Because of sociologic, politic, and scientific deficiencies subject remained untouched. We tried shedding some light on this ambiguous phenomenon.

MATERIAL AND METHODS

We report a 54-year-old man who was admitted to our neurosurgery outpatient department with epilepsy due to a sewing needle located in the left frontal lobe of the brain and made extensive literature review.

RESULT

Patient's physical and neurological examinations were completely normal. All biochemical and hematological tests were normal. Cranial tomography demonstrated a linear density at the left frontal lobe compatible with a sewing needle. Patient was followed-up with antiepileptic treatment with no seizure. Sixty cases from up-to-date literature and past cases were reviewed. Patients' ages differ from 4 days to 70 years. Our review showed four cases treated with antibiotics, 19 patients went to surgery, and others just followed-up with antiepileptic and other drugs.

CONCLUSION

Literature needs an autopsy series for a more intimate estimation. Due to psychosocial and legitimacy problems, matter should be handled cautiously and law enforcement agencies must be informed. Follow-up with medication is the first line of treatment with asymptomatic patients. Treatment is dictated by clinic onset, physical examination, and patient consent.

Asymptomatic Intracranial Foreign Body: An Incidental Finding on Radiography

Introduction

Intracranial needles are rare entities. Intracranial foreign bodies due to non-missile intracranial penetrations are one of the most rarely encountered situations in neurosurgery. Sewing needles are among the more unusual foreign bodies that may be found in the brain. Although uncommon, foreign body cases are important and interesting. Foreign bodies enter the body through trauma or iatrogenic injuries. Needles are mostly inserted through fontanelles, cranial sutures, and more rarely through the orbits in infancy for the purpose of killing unwanted babies.

Case Presentation

This article presents a case of intracranial foreign body found upon radiography. A 24-year-old female, who two days prior to presentation suffered only once from dizziness, and was otherwise healthy.

Conclusions

Because this incident may have occurred during the patient’s neonatal period, it may be a case of child abuse. In spite of the very limited number of cases in the literature, having a stepmother, a stepfather, or a babysitter, being the youngest child, or having family members who suffer from psychiatric disorders, (especially if these relatives are responsible for child care), living in a society that allows homicide of children born from extramarital relationships, and being female have been suggested as possible risk factors.

Migration of a sewing needle foreign body into the brainstem of a cat

CASE SUMMARY

A 1-year-old, female spayed domestic shorthair cat with a 6 week history of upper respiratory signs and a progressive reluctance to move, which culminated in a right-sided hemiparesis, was found to have a sewing needle foreign body lodged in the brainstem. Surgical extraction of the needle was successful and the cat's neurological deficits resolved over the days to weeks following its removal.

RELEVANCE AND NOVEL INFORMATION

This case report describes, to our knowledge, the first reported incidence and management of an ingested sewing needle migrating into the central nervous system of a cat.

A case of psychosis induced self-insertion of intracranial hypodermic needles causing seizures

Self-insertion of foreign bodies is a rare event. This report details a 56-year-old male who had self-inserted six hypodermic needles into his left frontal lobe 6 years previously. He subsequently presented with seizures and went on to have the needles surgically removed. This represents the first case of its type involving hypodermic needles. Given that intracranial needles are a rare finding, the management of such patients is complex. Two management issues in particular that require consideration are: (i) can the needles be left in situ and (ii) does removal of the needles reduce the risk of seizures in the long term?

A late-onset seizure in a child due to intracranial needle

Placing of sewing needles in the brain through the anterior fontanel is a rare entity. There are very few cases reported in literature. Most of them were asymptomatic, but some of them presented with seizure. We report here a 14-year-old boy, who was admitted to the Pediatric Neurology Department with a history of generalized tonic-clonic seizures due to sewing needle located in the frontal lobe.

Unexpected foreign body in the leg of an 8-month-old child

Accidents and injuries associated with foreign bodies are important causes of childhood mortality. Diagnosis can be facilitated by obtaining a detailed history, performing a physical examination and utilising simple imaging methods. We report a case involving a fragmented sewing needle in the left leg of an 8-month-old male infant. He was admitted to our clinic with diffuse pain in the left leg, limitation of leg movements and an inability to stand. The patient was successfully treated with open surgery under fluoroscopy. Soft tissue foreign bodies and potential child physical abuse should be considered in children with ambiguous symptoms and unusual skin lesions. Parents should be educated on prevention of household accidents involving children. Penetration of sewing needles into the body has been rarely reported in the literature. We thus report this case to draw attention to the complications and morbidity associated with a delayed diagnosis in such cases.

Intracranial metallic foreign bodies in a man with a headache

We report the case of a 22-year old man with intracranial metallic foreign bodies who presented complaining of a headache. His history of headaches had begun when he was five years old and continued with increasing severity. Six months before hospital admission, nausea and vomiting began to accompany his headache. Computed tomography scan revealed that 2 metallic foreign bodies were located adjacent to the vertex and another was next to the ambient cistern. The location and position of foreign bodies suggested that they were introduced in infancy through the anterior fontanelle before its closure in an unsuccessful homicide attempt. This case is one of the few reported cases combining headache and intracranial foreign bodies and we discuss the relationship between headache and these metallic materials.

Status epilepticus in a 52-year-old woman due to intracranial needle

Intracranial needles are a rare entity. They most commonly present with headache and seizures. The management of such patients is sometimes challenging. We present a 52-year-old woman who was admitted to our hospital with status epilepticus, because of an inracranial needle. There was no history of epileptic seizures and she was asymptomatic until the time of presentation.

An unusual case of cerebral penetrating injury by a driven bone fragment secondary to blunt head trauma

Temple trauma that appears initially localized to the skin might possess intracranial complications. Early diagnosis and management of such complications are important, to avoid neurologic sequelae. Non-penetrating head injuries with intracranial hemorrhage caused by a driven bone fragment are extremely rare. A 53-year-old male was referred to our hospital because of intracerebral hemorrhage. He was a mechanic and one day before admission to a local clinic, tip of metallic rod hit his right temple while cutting the rod. Initial brain computed tomography (CT) and magnetic resonance imaging demonstrated scanty subdural hematoma at right temporal lobe and left falx and intracerebral hematoma at both frontal lobes. Facial CT with 3-D reconstruction images showed a small bony defect at the right sphenoid bone's greater wing and a small bone fragment at the left frontal lobe, crossing the falx. We present the unusual case of a temple trauma patient in whom a sphenoid bone fragment migrated from its origin upward, to the contralateral frontal lobe, producing hematoma along its trajectory.