PMC8492425_01
Computed tomography on admission shows a foreign body penetrating right petrosal bone and petrosal bone fracture (a  ), traumatic subarachnoid hemorrhage (b  ) and subdural hemorrhage (c  ). The foreign body stay in the petrosal bone(d,e).
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F1
Computed tomography revealed that the body had penetrated the petrosal bone [Figure 1a], and traumatic subarachnoid hemorrhage [Figure 1b] and acute cerebellar tent area. Subdural hematoma was observed [Figure 1c], the internal auditory meatus was also deviated [Figures 1c and d]. and the body was close to the sigmoid sinus [Figure 2].
Temporal bone computed tomography on admission shows petrosal apex fracture. The inner ear canal was deviated inward (a). The carotid canal was not injured, but the foreign body was close to the sigmoid sinus (b).
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F2
Subdural hematoma was observed [Figure 1c], the internal auditory meatus was also deviated [Figures 1c and d]. and the body was close to the sigmoid sinus [Figure 2].
Digital subtraction angiography of the right common carotid artery (a and b) arterial phase; (c and d) venous phase; shows no extravasation, but the foreign body was close to the sigmoid sinus suggesting the possibility of injury or compression.
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F3
However, the sigmoid sinus was deviated, compression or damage due to the presence of foreign matter was suspected [Figure 3].
The red line demonstrates a skin incision line for craniotomy ( ) (a) and for adding craniotomy to expose the sigmoid sinus ( ). The extracted foreign body is about 8.7 cm in length (b).
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F4
The skin incision was designed in 2 pieces because we were able to rotate over a wide area to observe the vicinity of the middle fossa and sigmoid sinus [Figure 4].
Postoperative head computed tomography showing contusion of the right cerebellum. No postoperative bleeding was observed. (a) Brain window, (b) bone window.
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F5
The abdominal fat was filled in the mastoid air cell that had been removed to prevent cerebrospinal fluid leakage after the operation of closing the wound, and it was adhered with fibrin glue [Figure 5].