Management of Through-and-Through Penetrating Skull Injury: A Railroad Spike That Transgressed the Anterior Skull Base.

Abstract

Penetrating injuries involving foreign objects that transgress the entirety of the human skull present challenges in the management of vascular injuries, infectious risk, cerebrospinal fluid leak, and cosmetic repair. Ultimately, effective management of these injuries requires a multidisciplinary team and judicious surgical planning. Here we present the treatment of a patient who experienced a penetrating injury from a railroad spike, with entry and exit points involving the left and right anterior aspects of the temporal fossa, respectively. The rationale for management decisions is reviewed in the context of the published literature.