An obstinate intracranial bullet: a case report.

We report the case of a 52-year-old man with a history of psychiatric illness who sustained an intracranial gunshot wound. Within 20 hours, the bullet spontaneously migrated from the right to the left frontal lobe, as confirmed by two computed tomography scans, which led to a failed extraction in the operating theater. A decision was ultimately made not to reoperate. The patient is therefore currently living with a retained intracranial bullet and a decompensated psychiatric state. This case emphasizes the importance of perioperative imaging to adapt surgical planning and highlights the critical impact of bullet migration on prognosis and management.