Acute stroke secondary to intracranial arterial needle migration.

A 50-year-old man with a history of IV drug use and cervical scars presented with acute disorientation and incoherent speech. A cerebral CT demonstrated a left middle cerebral artery (MCA) infarct with intracranial linear hyperdensity (figure, A). CT angiography revealed a broken needle in the left internal and external carotid arteries (figure, B); there was apparent needle migration into the MCA (figure, B). No MRI was performed; the magnetic field may have moved the intracranial needle. Cervical needle fragments were removed surgically. Broken needle cardiac embolization associated with IV drug use has been reported,1,2 but intracranial arterial migration is exceptional.