Skip to main content

Retained Intracranial and Intraspinal Foreign Bodies

  • Chapter
  • First Online:
Imaging of Foreign Bodies

Abstract

Radiologic assessment of penetrating cranial or spinal injuries and possible resultant foreign bodies can include plain films, CT, and magnetic resonance imaging (MRI). Plain films are limited in their ability to delineate soft tissue and precisely localize radiopaque foreign bodies with respect to their intracranial or intraspinal location. This often necessitates a multidetector row computed tomography (MDCT) examination, which facilitates localization and better demonstrate other injuries such as fractures. While MDCT has much greater sensitivity than plain films in detecting foreign bodies, it may fail to detect wood fragments, as wood and air can have a similar hypodense CT appearance. MRI of penetrating cranial or spinal injuries may be limited or contraindicated by the metallic and/or ferromagnetic properties of the foreign body.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 59.99
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 79.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD 109.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

References

  1. Eggers G, Welzel T, Mukhamadiev D et al (2007) X-ray-based volumetric imaging of foreign bodies: a comparison of computed tomography and digital volume tomography. J Oral Maxillofac Surg 65:1880–1885

    Article  PubMed  Google Scholar 

  2. Eggers G, Mukhamadiev D, Hassfeld S (2005) Detection of foreign bodies of the head with digital volume tomography. Dentomaxillofac Radiol 34:74–79

    Article  PubMed  CAS  Google Scholar 

  3. Turbin RE, Maxwell DN, Langer PD et al (2006) Patterns of transorbital intracranial injury: a review and comparison of occult and non-occult cases. Surv Ophthalmol 51:449–460

    Article  PubMed  Google Scholar 

  4. Youssef AS, Morgan JM, Padhya T et al (2008) Penetrating craniofacial injury inflicted by a knife. J Trauma 64:1622–1624

    Article  PubMed  Google Scholar 

  5. Bhootra BL (2007) Retained intra cranial blade—medicolegal perspectives. J Forensic Leg Med 14:31–34

    Google Scholar 

  6. Taylor AG, Peter JC (1997) Patients with retained transcranial knife blades: a high-risk group. J Neurosurg 87:512–515

    Article  PubMed  CAS  Google Scholar 

  7. Kaufman HH (1991) Treatment of civilian gunshot wounds to the head. Neurosurg Clin North Am 2:387–397

    CAS  Google Scholar 

  8. Davis NL, Kahana T, Hiss J (2004) Souvenir knife: a retained transcranial knife blade. Am J Forensic Med Pathol 25:259–261

    Article  PubMed  Google Scholar 

  9. Salar G, Costella GB, Mottaran R et al (2004) Multiple craniocerebral injuries from penetrating nails. J Neurosurg 100:963

    Article  PubMed  Google Scholar 

  10. Fackler ML (1988) Wound ballistics. A review of common misconceptions. JAMA 259:2730–2736

    Article  PubMed  CAS  Google Scholar 

  11. Ragsdale BD (1984) Gunshot wounds: a historical perspective. Milit Med 149:301–315

    CAS  Google Scholar 

  12. Stone JA, Slone HW, Yu JS et al (1977) Gunshot wounds of the brain: influence of ballistics and predictors of outcome by computed tomography. Emerg Radiol 4:140–149

    Article  Google Scholar 

  13. Hansen JE, Gudeman SK, Holgate RC et al (1988) Penetrating intracranial wood wounds: clinical limitations of computerized tomography. J Neurosurg 68:752–756

    Article  PubMed  CAS  Google Scholar 

  14. Etherington RJ, Hourihan MD (1989) Localisation of intraocular and intraorbital foreign bodies using computed tomography. Clin Radiol 40:610–614

    Article  PubMed  CAS  Google Scholar 

  15. McGuckin JF, Akhtar N Jr, Ho VT et al (1996) CT and MR evaluation of a wooden foreign body in an in vitro model of the orbit. Am J Neuroradiol 17:129–133

    PubMed  Google Scholar 

  16. Coşar A, Gönül E, Kurt E, Gönül M, Taşar M, Yetişer S (2005) Craniocerebral gunshot wounds: results of less aggressive surgery and complications. Minim Invasive Neurosurg 48(2):113–118

    Article  PubMed  Google Scholar 

  17. Bhatoe HS (2001) Retained intracranial splinters: a follow up study in survivors of low intensity military conflicts. Neurol India 49(1):29–32

    PubMed  CAS  Google Scholar 

  18. Splavski B, Sisljagić V, Perić L, Vranković D, Ebling Z (2000) Intracranial infection as a common complication following war missile skull base injury. Injury 31(4):233–237

    Article  PubMed  CAS  Google Scholar 

  19. Fischer BR, Yasin Y, Holling M, Hesselmann V (2012) Good clinical practice in dubious head trauma—the problem of retained intracranial foreign bodies. Int J Gen Med 5:899–902

    Article  PubMed  Google Scholar 

  20. Teasdale G, Jennett B (1974) Assessment of coma and impaired consciousness. A practical scale. Lancet 2(7872):81–84

    Article  PubMed  CAS  Google Scholar 

  21. Maas AI, Stocchetti N, Bullock R (2008) Moderate and severe traumatic Brain injury in adults. Lancet Neurol 7(8):728–741

    Article  PubMed  Google Scholar 

  22. Teksam M, McKinney A, Truwit CL (2004) A retained neurointerventional microcatheter fragment in the anterior communicating artery aneurysm in multi-slice computed tomography angiography. Acta Radiol 45(3):340–343

    Article  PubMed  CAS  Google Scholar 

  23. Zoarski GH, Lilly MP, Sperling JS, Mathis JM (1999) Surgically confirmed incorporation of a chronically retained neurointerventional microcatheter in the carotid artery. AJNR Am J Neuroradiol 20(1):177–178

    PubMed  CAS  Google Scholar 

  24. Baghai P, Sheptak PE (1982) Penetrating spinal injury by a glass fragment: case report and review. Neurosurgery 11:419–422

    Article  PubMed  CAS  Google Scholar 

  25. Cybulski GR, Stone JL, Kant R (1989) Outcome of laminectomy for civilian gunshot injuries of the terminal spinal cord and cauda equina: review of 88 cases. Neurosurgery 24:392–397

    Article  PubMed  CAS  Google Scholar 

  26. Steinmetz MP, Krishnaney AA et al (2004) Penetrating spinal injuries. Neurosurg Q 14:217–223

    Article  Google Scholar 

  27. Waters RL, Sie IH (2003) Spinal cord injuries from gunshot wounds to the spine. Clin Orthop Relat Res 408:120–125

    Article  PubMed  Google Scholar 

  28. Williams DT, Chang DL, DeClerck MP (2009) Penetrating spinal cord injuries with retained canal fragments. CJEM 11:172–173

    PubMed  Google Scholar 

  29. Young WF Jr, Katz MR, Rosenwasser RH (1993) Spontaneous migration of an intracranial bullet into the cervical canal. South Med J 86(5):557–559

    Article  PubMed  Google Scholar 

  30. Kuijlen JM, Herpers MJ, Beuls EA (1997) Neurogenic claudication, a delayed complication of a retained bullet. Spine (Phila Pa 1976) 22(8):910–914

    Google Scholar 

  31. Doll M, Baum H (1989) Retained intraspinal bullet—an illustrative case report. Neurosurg Rev 12(1):67–70

    Article  PubMed  CAS  Google Scholar 

  32. Ajmal S, Enam SA, Shamim MS (2009) Neurogenic claudication and radiculopathy as delayed presentations of retained spinal bullet. Spine J 9(10):e5–e8

    Article  PubMed  Google Scholar 

  33. Fung CF, Ng TH (1992) Delayed myelopathy after a stab wound with a retained intraspinal foreign body: case report. J Trauma 32(4):539–541

    Article  PubMed  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Gianluigi Guarnieri .

Editor information

Editors and Affiliations

Rights and permissions

Reprints and permissions

Copyright information

© 2014 Springer-Verlag Italia

About this chapter

Cite this chapter

Guarnieri, G., Genovese, L., Muto, M. (2014). Retained Intracranial and Intraspinal Foreign Bodies. In: Pinto, A., Romano, L. (eds) Imaging of Foreign Bodies. Springer, Milano. https://doi.org/10.1007/978-88-470-5406-6_9

Download citation

  • DOI: https://doi.org/10.1007/978-88-470-5406-6_9

  • Published:

  • Publisher Name: Springer, Milano

  • Print ISBN: 978-88-470-5405-9

  • Online ISBN: 978-88-470-5406-6

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics