Doctors pull knife from man’s eye that went through his brain—and he’s fine now

The man then moved to intensive care, where he recovered rapidly. A day after surgery, doctors were able to remove his breathing tube. He developed some minor right-side weakness, but it resolved two days later. Scans of his brain showed steady improvement—a little bleeding and swelling, and there was some air in his brain tissue from where the knife had been. But otherwise, it appeared to be healing. He developed no infections and had no seizures.

Despite the “dramatic intracranial trajectory,” his language function was preserved, and he had no loss of movement or coordination, they reported. He was discharged from the hospital and at follow-up appointments remained “neurologically well,” with ongoing eye and mental health care.

Lucky recovery

As for how the injury happened, his doctors still don’t know. “The mechanism is unclear,” they wrote. However, they noted he had a history of depression.

The doctors reflected on how lucky the man was to have survived and to have such a full recovery. Such injuries that go through the eye and the brain are rare. When they do occur, they’re usually from “high-velocity mechanisms” such as gunshots or other ballistic injuries. Knives, rods, and nails fit into the rarer “low-velocity mechanisms. “Such “low-velocity penetrating brain injuries carry substantial morbidity and mortality because of hemorrhage, vascular injury, abscess, meningitis, cerebrospinal fluid leak, seizures and neurological deficit,” they wrote.

But such fortunate recoveries aren’t unheard of; they cited reports of other remarkably unexpected recoveries from seemingly devastating brain injuries. That includes the famous case of Phineas Gage, a railroad foreman who survived an 1848 accident that sent a large iron rod directly through his head. The rod entered below his left cheekbone and exited the top of his skull. (Although he survived and recovered, Gage’s personality was said to have changed after the accident. The doctors in the knife-wound case did not mention any such personality changes.)

“Echoing classic and contemporary examples of severe frontal lobe penetration with unexpectedly preserved neurological function, including Phineas Gage and a reported nail-gun injury, this case highlights that outcome may depend less on external severity than on precise trajectory relative to critical vascular, cortical and subcortical structures,” the doctors concluded.