We report the case of a penetrating injury due to a pruning shears. A 54-year-old male felt down from a stepladder and a pruning shears stuck his right ear. He was transferred to our emergency room in the state that a pruning shears stuck. At the time of removing another stretcher in our emergency room, a pruning shears was come out. Bloody cerebrospinal fluid (CSF) was flowed out from his right ear. His consciousness was normal and had no neurological deficit. A brain computed tomography (CT)

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... evealed intracranial air in the posterior fossa and penetrating fracture of the right pyramidal bone. Subarachnoid hemorrhage and brain contusion were not recognized. Three dimensional CT angiography (3D-CTA) revealed no damage of the major vessels. Instead of surgical craniotomy, spinal drainage was placed for 24 days. CSF leak was under control and not detected 21 hospital day. Meropenem hydrate (3.0g/day) was used prophylactically for 28 days and infectious complication was not occurred. Although slight sensorineural hearing loss remained, the patient returned his work. However, surgical operative strategy in penetrating injury cases is usually managed, there are some cases cured by conservative treatment.