Remarkable recovery after a cranio-cerebral injury produced by an impacted hot missile fragment: apparent 'regeneration' of the temporal lobe.

A facio-cranio-cerebral injury due to a large piece of shrapnel causing direct and heat damage to the temporal lobe is described. It was managed by initial dural repair which was followed by sloughing and repeated wound débridement, leaving an open cerebral wound communicating with a facial wound. Auto-rotation of the temporal lobe occurred, allowing split-skin grafting onto arachnoid mater to obtain dural closure. Further treatment of the facial wound by skin-grafting the cavity and prosthetic reconstruction allowed early return to society and a full rehabilitation programme.