Abstract
Here we present a very rare case of a woman with a bone fragment in the third ventricle of the brain following compound-depressed skull fractures due to a road traffic accident. There are only few case reports of bullets and textiloma being removed from the third ventricle. Following operative removal of the fragment, the patient was started on cortisol, mineralocorticoid and thyroid hormone replacement. However, the patient eventually died of the severe traumatic hypothalamic insult.
Highlights
We present a very rare case of a woman with a bone fragment in the third ventricle of the brain following compound-depressed skull fractures due to a road traffic accident
Since the patient was already extending and because there was already hemoventriculi, we opted for removal of the fragment despite its anatomical location so as to minimize further damage and chance of hydrocephalus
On the second post-operative day, the patient was started on ionotropic support because of the refractory hypotension, and was replaced with hydrocortisone, fludrocortisone and thyroid hormones
Summary
As brain abscesses may result from driven bone fragments and other retained foreign bodies in the brain, the removal of readily accessible foreign bodies has received much attention[3,4,5,6]. Migration of foreign bodies can occur because of gravitational force. Other routes of migration can be subdural, parenchymal, transventricular or along streamlining along the white matter track[7]. The removal of foreign bodies is mostly done via craniotomy[8,9], but other methods such as burr hole, stereotaxy[10] and sometimes by ventriculoscopy[11] have been described. Consent Informed written consent for publication of images and clinical details was obtained from the patient’s husband. Author contributions Sunil Munakomi wrote and submitted the manuscript. Grant information The author(s) declared that no grants were involved in supporting this work
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