LAUSR

BACKGROUND Intracranial penetrating traumas (IPTs) are rarely encountered in neurosurgery practice. Here, we report the case of a patient with orbital and cranial trauma caused by an unexpected object. CASE DESCRIPTION A 37-year-old male presenting with a right orbital penetrating injury was referred to our emergency department. Neurological examination of the patient revealed right periorbital ecchymosis, a dilated and fixed right pupil, and right hemiparesis. Cranial computed tomography showed fractures of the right orbital medial wall and the anterior skull base, and bifrontal and left parietal intracerebral hemorrhage accompanied by a metallic foreign body artifact. Emergency left frontoparietal decompressive craniectomy was performed and the foreign body, identified as a fishing sinker, was removed. No additional postoperative complications were observed, and cranioplasty was performed 6 months postoperatively. CONCLUSIONS IPTs have high morbidity and mortality rates. Early surgical intervention is often the first treatment option. Intracranial injury caused by a fishing sinker is an extremely rare low-energy IPT, and in the literature, this is the first reported case in which the patient survived.