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.
Access this chapter
Tax calculation will be finalised at checkout
Purchases are for personal use only
References
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
Eggers G, Mukhamadiev D, Hassfeld S (2005) Detection of foreign bodies of the head with digital volume tomography. Dentomaxillofac Radiol 34:74–79
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
Youssef AS, Morgan JM, Padhya T et al (2008) Penetrating craniofacial injury inflicted by a knife. J Trauma 64:1622–1624
Bhootra BL (2007) Retained intra cranial blade—medicolegal perspectives. J Forensic Leg Med 14:31–34
Taylor AG, Peter JC (1997) Patients with retained transcranial knife blades: a high-risk group. J Neurosurg 87:512–515
Kaufman HH (1991) Treatment of civilian gunshot wounds to the head. Neurosurg Clin North Am 2:387–397
Davis NL, Kahana T, Hiss J (2004) Souvenir knife: a retained transcranial knife blade. Am J Forensic Med Pathol 25:259–261
Salar G, Costella GB, Mottaran R et al (2004) Multiple craniocerebral injuries from penetrating nails. J Neurosurg 100:963
Fackler ML (1988) Wound ballistics. A review of common misconceptions. JAMA 259:2730–2736
Ragsdale BD (1984) Gunshot wounds: a historical perspective. Milit Med 149:301–315
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
Hansen JE, Gudeman SK, Holgate RC et al (1988) Penetrating intracranial wood wounds: clinical limitations of computerized tomography. J Neurosurg 68:752–756
Etherington RJ, Hourihan MD (1989) Localisation of intraocular and intraorbital foreign bodies using computed tomography. Clin Radiol 40:610–614
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
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
Bhatoe HS (2001) Retained intracranial splinters: a follow up study in survivors of low intensity military conflicts. Neurol India 49(1):29–32
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
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
Teasdale G, Jennett B (1974) Assessment of coma and impaired consciousness. A practical scale. Lancet 2(7872):81–84
Maas AI, Stocchetti N, Bullock R (2008) Moderate and severe traumatic Brain injury in adults. Lancet Neurol 7(8):728–741
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
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
Baghai P, Sheptak PE (1982) Penetrating spinal injury by a glass fragment: case report and review. Neurosurgery 11:419–422
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
Steinmetz MP, Krishnaney AA et al (2004) Penetrating spinal injuries. Neurosurg Q 14:217–223
Waters RL, Sie IH (2003) Spinal cord injuries from gunshot wounds to the spine. Clin Orthop Relat Res 408:120–125
Williams DT, Chang DL, DeClerck MP (2009) Penetrating spinal cord injuries with retained canal fragments. CJEM 11:172–173
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
Kuijlen JM, Herpers MJ, Beuls EA (1997) Neurogenic claudication, a delayed complication of a retained bullet. Spine (Phila Pa 1976) 22(8):910–914
Doll M, Baum H (1989) Retained intraspinal bullet—an illustrative case report. Neurosurg Rev 12(1):67–70
Ajmal S, Enam SA, Shamim MS (2009) Neurogenic claudication and radiculopathy as delayed presentations of retained spinal bullet. Spine J 9(10):e5–e8
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
Author information
Authors and Affiliations
Corresponding author
Editor information
Editors and Affiliations
Rights 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)