Crowbar impalement of the brain

The management of impaled foreign objects is always a challenge. Stabilization of the object, control of hemorrhage, and adherence to the basic principles of airway and breathing control are hallmarks of prehospital management. Once the patient is in the hospital, a careful assessment of the involved vital structures is essential before removal is attempted. A penetrating injury to the left hemisphere of the brain with a crowbar is presented. This case demonstrates the characteristics of these injuries in terms of extrication, assessment, management of complications, and neurologic sequelae.