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Hendricks BK, DiDomenico JD, Lawton MT, Little AS. Unique Presentation and Novel Surgical Approach to a Transcribriform Penetrating Head Injury Caused by a Nail Gun. Cureus 2022; 14:e25581. [PMID: 35784965 PMCID: PMC9249433 DOI: 10.7759/cureus.25581] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/27/2022] [Indexed: 11/15/2022] Open
Abstract
A penetrating head injury caused by a nail gun is an infrequent clinically diverse condition that varies in severity by the neurovascular structures involved. The authors present the case of a patient whose frontal lobe was pierced by a nail that entered via a transnasal transcribriform trajectory without causing vascular injury or intracranial hemorrhage; the man was unaware of the nail’s presence and presented with headache five days after the incident. The nail was extracted using a bifrontal craniotomy for direct visualization and for defect repair of the skull base combined with endoscopic endonasal extraction of the nail.
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Encarnacion-Ramirez MDJ, Aquino AA, Castillo REB, Melo-Guzmán G, López-Vujnovic D, Blas A, Acosta-Garcés R, Bernés-Rodríguez M, Guerra RM, Ayala-Arcipreste A, Nurmukhametov R, Efe IE. Surgical management of a penetrating drill bit injury to the skull base. Surg Neurol Int 2022; 13:49. [PMID: 35242415 PMCID: PMC8888304 DOI: 10.25259/sni_1229_2021] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2021] [Accepted: 01/22/2022] [Indexed: 11/17/2022] Open
Abstract
Background: Low-energy penetrating brain injuries are rarely encountered in neurosurgical practice. Immediate surgical management remains the primary treatment strategy to control potential bleeding and prevents infectious complications. Case Description: A 28-year-old man presented with an orbital injury with left-sided chemosis, amaurosis, and ophthalmoplegia following an assault. Cranial CT revealed an industrial drill bit causing a penetrating injury to the skull base. The tip of the object reached the petrous apex. CT angiography showed no signs of cerebrovascular damage. The drill bit was visualized through a frontotemporal craniotomy. It was then carefully removed under direct microscopic vision. Postoperative ceftriaxone was administered. The patient was discharged in good condition on postoperative day 6. His vision impairment remained. Conclusion: Timely access to neuroimaging diagnostics and microneurosurgical facilities allows for good outcomes in the surgical treatment of low-velocity penetrating brain injuries.
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Affiliation(s)
| | - Amaya Alvarez Aquino
- Department of Neurosurgery, International Center for Neurological Restoration, Havanna, Cuba, Mexico,
| | | | | | | | - Agustin Blas
- Department of Neurosurgery, Hospital Juárez de México, Mexico-City, Mexico,
| | | | | | | | | | - Renat Nurmukhametov
- Department of Neurosurgery, Peoples’ Friendship University of Russia, Moscow, Russian Federation,
| | - Ibrahim E. Efe
- Charité – Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany,
- Centre for Surgery Zurich, Klinik Hirslanden, Zurich, Switzerland
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3
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Yazar U. Penetrating craniocerebral nail gun injury in a child: a case report. Childs Nerv Syst 2021; 37:1345-1349. [PMID: 32671533 DOI: 10.1007/s00381-020-04800-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/14/2020] [Accepted: 07/09/2020] [Indexed: 10/23/2022]
Abstract
Penetrating craniocerebral injuries with a nail gun are extremely rare and even rarer in children. In this case, a 2-year-old boy, who was the youngest patient in the literature with an intracranial nail gun injury involving penetration of the right temporal lobe, was reported. The patient was evaluated by plain radiography and computed tomography. The nail was loosened and pulled gently out by creating a small craniotomy around the nail entrance. Although clinical characteristics and treatment methods of penetrating craniocerebral injuries were similar for reported in literature, the injury mechanism of presented case was different. Penetrating craniocerebral injuries with a nail gun are very dramatic situation, but mortality and morbidity are low. Without major vascular injury, a nail can be removed through a small incision. Penetrating injuries often occur accidentally in the pediatric age group, but the risk of child abuse should always be considered.
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Affiliation(s)
- Uğur Yazar
- Faculty of Medicine, Department of Neurosurgery, Karadeniz Technical University, Trabzon, Turkey.
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4
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Abstract
A 30-year-old man walked into the emergency department after a suicide attempt by firing a nail from a pneumatic nail gun directed at his left temple. He was haemodynamically stable and neurologically intact, able to recall all events and moving all extremities with a Glascow Coma Scale of 15. CT of the brain showed a 6.3 cm nail in the right frontal region without major intracerebral vessel disruption. He was taken to the operating room for left temporal wound washout, debridement of gross contamination and closure with titanium cranial fixation plate. The foreign body was not accessible on initial surgical intervention and was left in place to define anatomy and plan for subsequent removal. Thin slice CT images were used to create 3D reconstructions to facilitate stereotactic navigation and foreign body removal via right craniotomy the following day. The patient tolerated the procedures well and recovered with full neurological function.
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Affiliation(s)
- Roger Chen Zhu
- Department of Surgery, New York-Presbyterian Queens, Flushing, New York, USA
| | | | - Miroslav Kopp
- Department of Surgery, New York-Presbyterian Queens, Flushing, New York, USA.,Department of Surgery, Weill Cornell Medical College, New York, New York, USA
| | - Ning Lin
- Department of Surgery, New York-Presbyterian Queens, Flushing, New York, USA .,Department of Surgery, Weill Cornell Medical College, New York, New York, USA
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Ye CN, Lin MC, Huang CL. Double penetration wound: A nail gun injury involving the head and heart. Radiol Case Rep 2020; 15:334-338. [PMID: 31993095 PMCID: PMC6976870 DOI: 10.1016/j.radcr.2019.11.021] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2019] [Revised: 11/25/2019] [Accepted: 11/28/2019] [Indexed: 12/27/2022] Open
Abstract
Nail gun injuries usually occur at the extremities due to working accidents. Intracranial or intrathoracic injuries are relatively rare, and cases combined with both injuries are even rarer. Such situations pose challenges for surgeons due to their uniqueness during operation. Radiologic imaging findings in our case were significant in indicating surgical findings. Herein, we report a patient who shot himself using a nail gun, damaging his brain and heart.
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Affiliation(s)
- Ciou-Nan Ye
- Department of General Medicine, Kaohsiung Medical University Hospital, Kaohsiung City, Taiwan
| | - Ming-Chieh Lin
- Department of General Medicine, Kaohsiung Medical University Hospital, Kaohsiung City, Taiwan
| | - Chien-Lin Huang
- Department of Cardiovascular Surgery, Kaohsiung Medical University Hospital, No.100, Tzyou 1st Rd., Sanmin Dist., Kaohsiung City 80756, Taiwan
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Nussbaum ES, Graupman P, Patel PD. Repair of the superior sagittal sinus following penetrating intracranial injury caused by nail gun accident: case report and technical note. Br J Neurosurg 2019:1-5. [PMID: 31220943 DOI: 10.1080/02688697.2019.1630550] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
We report a 45-year-old man who suffered a penetrating nail gun injury resulting in damage to the lateral edge of the superior sagittal sinus. The injury was successfully treated via a parasagittal craniotomy that enabled removal of the nail under direct vision, allowing for rapid suturing of the sagittal sinus. Two neurosurgeons worked together; one carefully withdrew the tip of the nail back into the sinus itself while the second rapidly sutured the hole in the inner superior sagittal sinus leaflet. Postoperatively, the patient made a rapid recovery without neurological deficit.
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Affiliation(s)
- Eric S Nussbaum
- a National Brain Aneurysm & Tumor Center, Department of Neurosurgery , United Hospital , St Paul , MN , USA
| | - Patrick Graupman
- a National Brain Aneurysm & Tumor Center, Department of Neurosurgery , United Hospital , St Paul , MN , USA
| | - Puja D Patel
- b Department of Neuroscience , University of Southern California , Los Angeles , CA , USA
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Pniel D, Withers TK. A case of multiple nail gun injuries to the head and one to the heart. Surg Neurol Int 2018; 9:221. [PMID: 30533268 PMCID: PMC6238325 DOI: 10.4103/sni.sni_75_18] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2018] [Accepted: 06/27/2018] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND Nail gun injuries, while uncommon, can present significant treatment challenges. Many are often caused by work-related accidents, they have also been seen in suicide attempts and assaults. CASE DESCRIPTION A 53-year-old male was transferred from a peripheral hospital to a tertiary center after being found confused and with a left-sided weakness. Initial scans showed four nails penetrating the skull, with one additional nail in the pericardium. These all underwent surgical removal, and due to meticulous pre- and perioperative planning, the patient had a largely uneventful recovery. CONCLUSION The challenging nature of these injuries requires extensive workup prior to surgical decision-making in order to minimize potential complications.
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Affiliation(s)
- Dorian Pniel
- Department of Neurosurgery, Gold Coast University Hospital, Gold Coast, Queensland, Australia
| | - Teresa K. Withers
- Department of Neurosurgery, Gold Coast University Hospital, Gold Coast, Queensland, Australia
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Voss JO, Thieme N, Doll C, Hartwig S, Adolphs N, Heiland M, Raguse JD. Penetrating Foreign Bodies in Head and Neck Trauma: A Surgical Challenge. Craniomaxillofac Trauma Reconstr 2018; 11:172-182. [PMID: 30087746 DOI: 10.1055/s-0038-1642035] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2017] [Accepted: 12/29/2017] [Indexed: 10/17/2022] Open
Abstract
Penetrating foreign bodies of different origins in the head and neck are rare and potentially dangerous injuries, which might pose problems for their detection, primary care, and final treatment. Depending on the severity of the underlying trauma, some injuries present a higher risk for the presence of foreign bodies. Minor wounds, including common lacerations, are likely to be contaminated with loose gravel debris or dental fragments, and need to be distinguished from severe wounds caused by impalement, shootings, stabbings, and explosions. Blast injuries resulting from terror attacks are challenging recent therapeutic concepts. Even though these injury patterns are uncommon, they carry the risk of impacted objects with dramatic consequences. Despite improving medical imaging techniques, detection remains a challenge as it is dependent on the material of the foreign body, the affected anatomical site, and the injury severity. Therefore, a detailed history of the circumstances leading to trauma is essential when foreign objects are not visible during clinical examination. Precise detection of the foreign body, its anatomical position, and the affected surrounding structures are vital, especially for impalement injuries of the head and neck area. Therefore, an interdisciplinary planning approach is essential prior to removal of the foreign object. Finally, tension-free anatomical adaptation of the corresponding structures is crucial for maintaining and restoring aesthetic and function. Here, we give an overview of the diagnosis and treatment of cases of foreign body injuries encountered in our department.
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Affiliation(s)
- Jan Oliver Voss
- Department of Oral and Maxillofacial Surgery, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Berlin, Germany
| | - Nadine Thieme
- Department of Diagnostic and Interventional Radiology and Nuclear Medicine, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universitaät zu Berlin, and Berlin Institute of Health, Berlin, Berlin, Germany
| | - Christian Doll
- Department of Oral and Maxillofacial Surgery, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Berlin, Germany
| | - Stefan Hartwig
- Department of Oral and Maxillofacial Surgery, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Berlin, Germany
| | - Nicolai Adolphs
- Department of Oral and Maxillofacial Surgery, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Berlin, Germany
| | - Max Heiland
- Department of Oral and Maxillofacial Surgery, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Berlin, Germany
| | - Jan-Dirk Raguse
- Department of Oral and Maxillofacial Surgery, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Berlin, Germany
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Kato H, Kanno S, Ohtaki J, Nakamura Y, Horita T, Fukuta M, Eguchi K, Hassan Gaballa M, Aoki Y. A case of transnasal intracranial penetrating injury with skull base fracture caused by a broken golf club shaft. Leg Med (Tokyo) 2018; 32:57-60. [PMID: 29549791 DOI: 10.1016/j.legalmed.2018.03.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2017] [Revised: 02/06/2018] [Accepted: 03/11/2018] [Indexed: 11/30/2022]
Affiliation(s)
- Hideaki Kato
- Department of Forensic Medicine, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan.
| | - Sanae Kanno
- Department of Forensic Medicine, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan
| | - Jun Ohtaki
- Department of Forensic Medicine, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan
| | - Yoshimi Nakamura
- Department of Forensic Medicine, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan
| | - Tetsuya Horita
- Department of Forensic Medicine, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan
| | - Mamiko Fukuta
- Department of Forensic Medicine, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan
| | - Kazuhito Eguchi
- Department of Forensic Medicine, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan
| | - Mohamed Hassan Gaballa
- Department of Forensic Medicine, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan
| | - Yasuhiro Aoki
- Department of Forensic Medicine, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan
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Drosos E, Giakoumettis D, Blionas A, Mitsios A, Sfakianos G, Themistocleous M. Pediatric Nonmissile Penetrating Head Injury: Case Series and Literature Review. World Neurosurg 2018; 110:193-205. [DOI: 10.1016/j.wneu.2017.11.037] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2017] [Revised: 11/06/2017] [Accepted: 11/07/2017] [Indexed: 10/18/2022]
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Wu R, Ye Y, Liu C, Yang C, Qin H. Management of Penetrating Brain Injury Caused by a Nail Gun: Three Case Reports and Literature Review. World Neurosurg 2018; 112:143-147. [PMID: 29410036 DOI: 10.1016/j.wneu.2018.01.127] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2017] [Revised: 01/15/2018] [Accepted: 01/16/2018] [Indexed: 12/28/2022]
Abstract
BACKGROUND Penetrating brain injury (PBI) caused by a nail gun is an extremely rare neurosurgical emergency that poses a challenge for neurosurgeons because of its rarity and complexity. CASE DESCRIPTION Here we present 3 cases of PBI caused by a nail gun. In the first case, the nail entered through the right parietal bone and lodged in the right parietal lobe and basal ganglia. In the second case, the nail entered through the right occipital bone and lodged in the right occipital lobe. In the third case, the nail entered through the right parietal bone and lodged in the right frontal and parietal lobes. All patients underwent surgical removal of the nail. The first patient presented with reduced left-side strength, whereas the second and third patients were neurologically intact on presentation. CONCLUSIONS PBI caused by a nail gun can present with differing clinical manifestations, and most cases require immediate surgery. A rational management strategy should provide a good postoperative prognosis with minimal neurologic deficits in these patients.
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Affiliation(s)
- Ruhong Wu
- Department of Neurosurgery, The Third Affiliated Hospital of Soochow University, Changzhou City, China
| | - Yun Ye
- Department of Neurosurgery, The Third Affiliated Hospital of Soochow University, Changzhou City, China
| | - Chunbo Liu
- Department of Neurosurgery, The Third Affiliated Hospital of Soochow University, Changzhou City, China
| | - Changchun Yang
- Department of Neurosurgery, The Third Affiliated Hospital of Soochow University, Changzhou City, China
| | - Huaping Qin
- Department of Neurosurgery, The Third Affiliated Hospital of Soochow University, Changzhou City, China.
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Ishigami D, Ota T. Traumatic Pseudoaneurysm of the Distal Anterior Cerebral Artery Following Penetrating Brain Injury Caused by a Crossbow Bolt: A Case Report. NMC Case Rep J 2017; 5:21-26. [PMID: 29354334 PMCID: PMC5767482 DOI: 10.2176/nmccrj.cr.2017-0083] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2017] [Accepted: 06/15/2017] [Indexed: 12/02/2022] Open
Abstract
Traumatic intracranial aneurysms are one possible complication after penetrating brain injury. A 25-year-old man with a history of major depression presented with a crossbow bolt penetrating the head. On arrival, Glasgow Coma Scale score was E4V5M6, with no apparent neurological deficit. Computed tomography (CT) of the head showed the crossbow bolt passing near the corpus callosum, with surrounding contusion. Three-dimensional rotational angiography showed no anterior cerebral artery injuries. The crossbow bolt was removed after bifrontal craniotomy, with no postoperative infection. Postoperative CT angiography (CTA) was repeatedly performed, and a 4 mm aneurysm was observed at the pericallosal artery-right posterior internal frontal artery (PIFA) bifurcation on postoperative day (POD) 35. Trapping and the right PIFA-left cortical branch side-to-side bypass were performed on POD38. A resected specimen confirmed a pathological diagnosis of pseudoaneurysm. The patient did not show any neurological deficit or cognitive dysfunction as of 8 months after admission. Traumatic anterior cerebral artery aneurysm might have formed due to proximity to the falx cerebri. As pseudoaneurysm was detected 4 weeks after trauma in our patient, follow-up CTA or digital subtraction angiography should be performed until at least 4 weeks after injury. In addition, neck clipping is occasionally unfeasible to treat traumatic pseudoaneurysm surgically, and a surgical strategy including bypass revascularization must be planned.
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Affiliation(s)
- Daiichiro Ishigami
- Department of Neurosurgery, Tokyo Metropolitan Tama Medical Center, Fuchu, Tokyo, Japan
| | - Takahiro Ota
- Department of Neurosurgery, Tokyo Metropolitan Tama Medical Center, Fuchu, Tokyo, Japan
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Awori J, Wilkinson DA, Gemmete JJ, Thompson BG, Chaudhary N, Pandey AS. Penetrating Head Injury by a Nail Gun: Case Report, Review of the Literature, and Management Considerations. J Stroke Cerebrovasc Dis 2017; 26:e143-e149. [DOI: 10.1016/j.jstrokecerebrovasdis.2017.04.004] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2016] [Accepted: 04/03/2017] [Indexed: 11/26/2022] Open
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Bilateral nail gun traumatic brain injury presents as intentional overdose: A case report. CAN J EMERG MED 2017; 20:788-791. [PMID: 28264750 DOI: 10.1017/cem.2017.5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
This report describes a rare but life-threatening case of a suicide attempt initially considered as intentional overdose at the emergency department. Persistent altered mental status, despite normal toxicology investigations, led the attending team to order a head computed tomography scan, which revealed a bilateral penetrating nail gun injury with a right temporal hematoma for which a decompressive craniectomy was performed. Although voluntary intoxication is the most frequent form of suicide attempt, emergency physicians must be alert and maintain a broad differential diagnosis. Although rare, penetrating head injuries have increased in recent decades. As neurological symptoms can be minimal and penetration wounds small, this type of injury could potentially be overlooked.
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Zyck S, Toshkezi G, Krishnamurthy S, Carter DA, Siddiqui A, Hazama A, Jayarao M, Chin L. Treatment of Penetrating Nonmissile Traumatic Brain Injury. Case Series and Review of the Literature. World Neurosurg 2016; 91:297-307. [DOI: 10.1016/j.wneu.2016.04.012] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2015] [Revised: 04/03/2016] [Accepted: 04/04/2016] [Indexed: 10/22/2022]
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16
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Agu CT, Orjiaku ME. Management of a nail impalement injury to the brain in a non-neurosurgical centre: A case report and review of the literature. Int J Surg Case Rep 2015; 19:115-8. [PMID: 26745316 PMCID: PMC4756179 DOI: 10.1016/j.ijscr.2015.12.035] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2015] [Revised: 12/03/2015] [Accepted: 12/17/2015] [Indexed: 11/24/2022] Open
Abstract
This nail impalement injury to the brain was self-inflicted by a mentally challenged person who presented in a non-neurosurgical centre. After clinical assessment and limited investigations, a burr hole adjoining the nail was made by the orthopaedic team to loosen the nail and to carry out a successful extraction. The patient’s headache resolved swiftly and his limb weakness recovered fully by four months.
A nail impalement injury to the brain usually results from accidents like falls or nail gun miss-fires or suicide attempts or from barbaric punishment for certain crimes which are rarely practiced in some remote areas. We present an unusual, intentional, self-impalement of a 4 in. nail into the brain in a mentally challenged young man. This case report describes the challenges encountered in the management of a patient with impaled nail in the brain in a non-neurosurgical centre.
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Affiliation(s)
- Chika Thaddeus Agu
- Consultant Orthopaedic & Trauma Surgeon and Lecturer Imo State University, Owerri, Nigeria.
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Zhang HY, Li D, Wu Z, Zhang LW, Zhang JT. A Case Involving Needles in the Medulla Oblongata, Cervical Spinal Cord, and Abdomen. NMC Case Rep J 2014; 1:16-19. [PMID: 28663946 PMCID: PMC5364938 DOI: 10.2176/nmccrj.2013-0334] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2013] [Accepted: 12/06/2013] [Indexed: 11/20/2022] Open
Abstract
It is extremely rare to encounter intracranial foreign bodies caused by penetrating injuries other than gunshot wounds or low-velocity wounds. We present a case describing a 5-year-old girl with metallic foreign bodies in the medulla oblongata, cervical spinal cord, and abdomen. The foreign bodies may have been there and remained silent for several years until the patient developed nausea and vomiting that persisted for 3 months. A craniotomy and a laparotomy were performed after a thorough discussion. Five pieces of metallic foreign bodies were removed, and the patient had a good outcome. Despite the precarious location of the needles in the medulla oblongata and cervical spinal cord, this rare case supports the use of surgery to remove the foreign bodies.
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Affiliation(s)
- Hao-Yu Zhang
- Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Da Li
- Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Zhen Wu
- Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Li-Wei Zhang
- Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Jun-Ting Zhang
- Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
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18
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Thirteen intracranial nails: no neurological and neuropsychological disabilities. Acta Neurochir (Wien) 2014; 156:1021-3. [PMID: 24676987 DOI: 10.1007/s00701-014-2060-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2013] [Accepted: 03/07/2014] [Indexed: 10/25/2022]
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