[Deep penetrating brain injury with 20 years of asymptomatic survival: a case report]

Authors report the case of penetrating injury of the head with large metallic fragment embedded to the brain with 20 years asymptomatic survival. Patient sustained head injury during work, 20 years ago and for these period of time was not aware of having foreign body intracranially with excellent general condition and no signs of neurological deficit. Metal nail was detected incidentally by plain skull X-ray films (and subsequent CT scan) during routine procedures when patient was admitted to the Laryngologic Dpt. for surgical procedure. In our opinion presented case in uncommon because of asymptomatic course. Most of penetrating head injuries are considered as life threatening due to sudden onset, severe general patient condition and possible deterioration according to the type of injury and extent of cerebral destruction. For those reasons earliest possible definitive neurosurgical treatment is recommended. We emphasize the role of debridement for most of brain penetration injuries.