Transcranial brain injuries caused by metal rods and pipes over the past 150 years.

Penetrating through and through (transcranial) injuries of the head and brain by foreign bodies other than bullet or shrapnel are extremely unusual. Although the case of Phineas Gage (1848) has been the most widely publicized, and stimulated much interest in brain function, additional surviving cases of through and through brain penetration by bars, rods or pipes have been reported. The author reviews 12 published cases over the last 150 years and describes two additional cases. The management of these cases is described. This group of patients for the most part experienced a functional outcome despite neurologic deficits.