# A curious case of unsuspected intracranial metallic splinter with complications

## TL;DR

A young man suffered delayed complications from a small metal fragment in his brain after a seemingly minor injury.

## Contribution

Highlights the importance of imaging and managing delayed complications in non-missile brain injuries.

## Key findings

- A 2.5 cm metallic splinter was found in the cerebellum months after a trivial injury.
- The patient developed meningitis, hydrocephalus, and a pseudocyst requiring multiple interventions.
- Routine imaging and individualized management are critical for such injuries.

## Abstract

Penetrating injuries to the brain, due to low-velocity, non-missile objects are rare in civilian lament, but can carry significant
morbidity. We describe a 20-year-old male with altered sensorium, headache and imbalance, months following what was deemed a trivial head
injury from cricket. After imaging, a 2.5 cm metallic splinter lodged in the left cerebellum, which was subsequently surgically removed.
The patient developed meningitis and hydrocephalus, required a shunt thereafter, but was complicated by the development of a pseudocyst,
cherry-picking a CSF leak, malfunction of the original shunt and he ultimately had to be managed with a ventriculoarterial shunt. Thus,
the need for routine imaging, expedited clinical recognition and individual management of delayed complications for penetrating injuries
with the brain.