Intracranial drilling wounds related to falling from high places are rarely seen. The methods that are used in diagnosis, and developing complications, and treatment procedures can be changed according to the shape of trauma, and to the entry place of foreign body, and to the situation of patient. An eleven years old boy was brought to our clinic with complaint of head down falling from roof on the top of an iron spit. In his examination, the iron spit entered from inferior of right mandible and passed through to the brain parenchyma and came out of left frontal zone. On admission, the Glasgow Coma Scale was 15/15. At the operating room of emergency service the iron spit was taken out under local anesthesia without needing craniotomy. The patient who had no complication without ptosis on right lid, and deviated pupil to left side was discharged at his twelfth days of admission.
As a result, in intracranial foreign bodies if not more then one lobe had been damaged, and one site of body is outside, the foreign body can be taken out carefully without needing craniotomy.
Keywords: Iron spit, craniotomy, local anesthesia, ptosis