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Images in Neurology
October 2004

A Migrated Acupuncture Needle in the Medulla Oblongata

Arch Neurol. 2004;61(10):1608. doi:10.1001/archneur.61.10.1608

A 70-year-old man was referred to our institution for evaluation of an acupuncture needle that had been accidentally broken 3 weeks earlier. The neurological examinations revealed no sensory or motor disturbances. A plain x-ray film and a computed tomographic (CT) scan (Figure 1) showed a needle in the cervical spinal cord penetrating the medulla oblongata. A reconstructed 3-dimensional CT scan using a 4-channel multidetector CT scanner (Aquillion; Toshiba, Japan) demonstrated the needle from the right caudal to the left cranial at the level of the foramen magnum (Figure 2). Because of treatment-related morbidity and mortality, surgical removal was not performed. At the 1-year follow-up, the patient developed increased left facial paresthesia. After consulting with a neurosurgeon, he decided not to undergo surgical removal of the needle because of treatment-related morbidity and mortality.

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