A temporal head injury involving intracranial penetration by glass

The authors report a rare case of intracranial glass injury due to a temporal head injury. This 72-year-old man slipped on a bathroom floor, impacting a glass door with his head and right shoulder. His right temporal scalp and right shoulder were cut by the broken glass. He visited our emergency unit four hours after sustaining the injury. Physical and neurological examinations showed no abnormalities except for two lacerated wounds on both the right temporal scalp (1.5cm) and the right shoulder skin (10cm). Foreign bodies were not palpable around the lacerated wounds. Skull X-ray and CT studies disclosed a single, 5-cm long, radiopaque foreign body penetrating the temporal skull bone into the right temporal lobe, but no evidence of intracranial bleeding was found. Under the diagnosis of intracranial glass injury, total removal of the foreign body with dural repair was carried out. On surgical exploration, glass penetrating the skull bone 5-mm distant anteriorly to the scalp laceration was observed. Postoperative angiography showed no vascular lesions, and one-week later he was discharged with no complications. According to the literature, most of the intracranial foreign bodies occur around the orbital, the frontal sinus, and the nasal areas. To our knowledge, this is the first report of an intracranial glass penetrating injury to the temporal lobe. Since the clinical manifestations occasionally do not correspond to the appearance of the laceration after glass penetrating injuries, serious caution concerning patients with intracranial glass penetrating injuries is important.