A curious case of unsuspected intracranial metallic splinter with complications

Penetrating injuries to the brain, due to low-velocity, non-missile objects are rare in civilian lament, but can carry significant morbidity. We describe a 20-year-old male with altered sensorium, headache and imbalance, months following what was deemed a trivial head injury from cricket. After imaging, a 2.5 cm metallic splinter lodged in the left cerebellum, which was subsequently surgically removed. The patient developed meningitis and hydrocephalus, required a shunt thereafter, but was complicated by the development of a pseudocyst, cherry-picking a CSF leak, malfunction of the original shunt and he ultimately had to be managed with a ventriculoarterial shunt. Thus, the need for routine imaging, expedited clinical recognition and individual management of delayed complications for penetrating injuries with the brain.