An unusual case of penetrating skull injury

Abstract Penetrating injury to the skull with a sharp object such as a screw driver is unusual and requires emergent and assiduous management. A middle aged male had presented to us with such an injury with the penetrating object embedded firmly in his temporal bone going intracranially. He underwent craniotomy with careful removal of the embedded object whose tip was rooted in the petrous temporal bone and barely missing the vital structures like petrous carotid artery and the inner ear. Patient had an uneventful post op course and follow up of 8 weeks. A penetrating screwdriver injury to the skull is a rare occurrence with high morbidity and mortality. Imaging to ascertain the intracranial structures involved followed by early and careful retrieval in the operating room form the mainstay of treatment.