The Arrow and the Atlas-A Narrow Escape in the Cervical Spine: A Case Report About Penetrating Injury With an Arrow Impacted in the Neck.

Penetrating neck injuries (PNI) are a rare presentation of all trauma cases. A rational strategy and prompt patient assessment are necessary for management. Selective treatment has replaced mandatory exploration in the treatment of penetrating neck trauma. A 41-year-old male patient was admitted to the emergency department with an arrow penetrating the neck, without signs of neurological deficit. He had an arrow impacted into the right posterolateral aspect of his neck just posterior to the sternocleidomastoid muscle, corresponding to the axial level of the C1-C2 vertebra. The arrow was dislodged after extending the entry wound and removed with a gentle maneuver in the operating room with an uneventful postoperative period and follow-ups. Although PNIs are rare, a thorough understanding of the anatomy in this area is essential. Direct withdrawal in a controlled setting may be an excellent option for penetrating cervical and posterior neck injuries by a foreign body that is away from the neurovascular and aerodigestive tracts and in a hemodynamically stable patient.