Intracranial bullet retained since the Sino-Japanese war manifesting as hallucination--case report

A 69-year-old male with an intracranial bullet retained in the right occipital lobe for 45 years presented with epileptic seizure occasionally accompanied by visual hallucinations. Neurological examination revealed left homonymous hemianopsia and right hearing loss, and electroencephalography showed slow discharges localized in the lesion. The bullet was removed together with the thickened fibrous capsule. His postoperative course was uneventful, and he has become seizure-free. The bullet caused metal toxicity and progressive gliosis, which caused the epileptogenetic focus and associated hallucinations.