Introduction of Sharp Objects in to Brain With Infanticidal Intention

Child abuse, malicious and deliberate intention of harming or killing a child, is well-documented in history and is more hideous in infants due to their disability to communicate and defend, making them more susceptible victims for such a crime. Embedding sewing needle(s) into brain through natural openings and soft parts of the cranium has been reported for infanticide purpose (1). The relative small number of reported cases in medical literature does not match the real number of cases due to missed-detections, lack of physician referral or infant death before disclosure of respective cause (1, 2). A 57-year-old man presented with symptoms of an ischemic cerebrovascular accident (CVA). Brain CT scan revealed a left middle cerebral artery territory infarct and surprisingly a metallic foreign body embedded in midfrontal region slightly deviated to the right (Figure 1 A) that proved to be artifacts of a sewing needle on plain Xrays (Figure 1 B). The site of entry seemed to be anterior fontanel showed as a dimple on 3D CT reconstruction of the skull (Figure 1 C). There was no record or sign of previous trauma or any surgical procedures on the scalp, skull or brain. The family denied any unusual childhood or infancy background including non-parental babysitter or stepmother. Past medical history lacked of any relevant symptoms attributable to the presence of foreign body in the brain. Finally, we came to conclusion that this was an accidental finding.