Intracranial penetrating injury by clothes fork in an infant: case report and review of the literature

Childs Nerv Syst. 2023 Jan;39(1):47-55. doi: 10.1007/s00381-022-05706-1. Epub 2022 Oct 22.

Abstract

Nonmissile intracranial penetrating injury (IPI) in pediatric population is rare. Here, we report the exceedingly rare case of a 5-month-old infant sustained by a metallic clothes fork penetrating into his left forehead. The little baby was identified to carry a traumatic hemorrhagic shock, and a multidisciplinary team (MDT) was immediately established response for whole-course evaluation and decision-making. Computed tomography revealed that the clothes fork had impaled into the left frontal bone and brain parenchyma with about 3.2 cm inside the cranial vault. The infant underwent emergency surgery, and the clothes fork was removed jointly by MDT members under general anesthesia in the retrograde direction. His recovery was uneventful and was followed up 2 years without growth and developmental abnormality. As an extremely rare entity with distinct age-related characteristics, a MDT approach is a best choice and effective strategy to manage infant nonmissile IPI, including preoperative management, surgical treatment, and even following rehabilitation.

Keywords: Infant; Intracranial penetrating injury; Multidisciplinary team; Skull fracture.

Publication types

  • Case Reports
  • Review

MeSH terms

  • Brain
  • Child
  • Craniocerebral Trauma* / surgery
  • Head Injuries, Penetrating* / surgery
  • Humans
  • Infant
  • Skull
  • Tomography, X-Ray Computed
  • Wounds, Penetrating* / surgery