Perforating head injury with iron rod and its miraculous escape: Case report and review of literature.

Civilian perforating head injury is rare. Because rarity of this injury, there is no standard management protocol. We report a case of perforating head injury with iron rod, review the literature on the subject and discuss the challenges in the management of such case. We have not found similar case in the literature. Civilian perforating head injury is rare. A 25-year-male brought to the emergency department with approximately two feet perforating iron rod in the head, entering via frontal region, left side of midline and coming out of the occipital region. He developed right sided hemiplegia and global aphasia. He underwent series of imaging for the evaluation of the course of the iron rod and injury sustained because of it. Under strict aseptic precaution, iron rod removed in the operation theater. His clinical condition improved over a period of three weeks. At one year follow up- he had almost normal speech and language functions and was able to walk without support. This case illustrates the possibility of bizarre type of such injury in the presence of protective helmet and challenges in the management. Preoperative planning on the basis of images, prophylactic antibiotics and anticonvulsant medications, cleaning of the objects with antiseptic solutions, anterograde extraction after adequate exposure around entry and exit points resulted in good clinical outcome after successful removal of the rod.