Hidden Threat: A Delayed Diagnosis of an Intracranial Impacted Car Key Leading to Brain Abscess

Penetrating cranial injuries involving retained foreign objects are rare but can lead to life-threatening complications including infections and neurological deficits. We report the case of a 38-year-old man with persistent headaches one week after sustaining a minor head injury during an assault. Initial evaluation by an independent practitioner revealed a small left temporal wound that was conservatively treated. However, a brain computed tomography revealed an intracranial foreign body, later identified as a car key, penetrating the left temporal bone and abscess formation. Surgical management included a craniotomy for foreign body removal, abscess evacuation, and postoperative antibiotic therapy. This case highlights the importance of thorough assessment and imaging in head trauma cases, even when the initial symptoms appear mild. Early detection and management of retained foreign objects are essential to prevent severe complications.