CT in a case of intracranial penetration of a pencil

Summary

A case is reported of an unusual foreign body, a pencil, penetrating the right temporal lobe through the squamous temporal bone in a fall. Wood has low attenuation coefficients, so that the appropriate CT examination includes multiple window settings to permit accurate assessment of bone fragment displacement as well as recognition of detached wood splinters. CT scanning and early surgery are important steps in the management of these injuries to reduce significantly the overall mortality as well as immediate and long term complications. The necessity for meticulous surgical technique when removing the foreign body is stressed as retained wood can not easily be visualized against the hypodense background due to postoperative changes.