Successful removal of an impacted metallic arrowhead penetrating up to the brainstem

A case of impacted metallic arrowhead in the brain through an unusual route of the neck and behind the external carotid artery to the base of the skull up to the brainstem is reported. Review of the literature reveals no previous reports of this type of injury. A 35-year-old man was admitted to the hospital after 36 h of injury, being fully conscious and with partial facial palsy. The arrowhead was successfully removed by exploration of the entry wound, without any neurovascular complications. The patient not only survived the operation but was also discharged in an improved neurological condition.