Transfacial transcranial penetrating fishing arrow injury with intact neurological examination: controlled intraoperative shortening and extraction. Illustrative case

For elongated metallic skull penetrating injuries, CTA‑guided planning, avoidance of blind extraction, and controlled OR removal augmented by intraoperative shortening when needed are key to minimizing hemorrhage and neurological injury. https://thejns.org/doi/10.3171/CASE25670.