Penetrating Head Injury by a Nail Gun: Case Report, Review of the Literature, and Management Considerations

Our objective is to discuss penetrating head injuries (PHIs) which, although rare, lead to considerable morbidity and mortality. One of the most significant culprits of PHI is the nail gun, which was introduced in 1959 and has gained substantial popularity. We describe our successful strategy for re...

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Bibliographic Details
Published in:Journal of stroke and cerebrovascular diseases 2017-08, Vol.26 (8), p.e143-e149
Main Authors: Awori, Jonathan, MFA, Wilkinson, D. Andrew, MD, Gemmete, Joseph J., MD, Thompson, B. Gregory, MD, Chaudhary, Neeraj, MBBS, Pandey, Aditya S., MD
Format: Article
Language:English
Subjects:
Balloon Occlusion
Cardiovascular
Cerebral Angiography
Eye Injuries, Penetrating - diagnostic imaging
Eye Injuries, Penetrating - etiology
Eye Injuries, Penetrating - surgery
Foreign Bodies - diagnostic imaging
Foreign Bodies - surgery
Head Injuries, Penetrating - diagnostic imaging
Head Injuries, Penetrating - etiology
Head Injuries, Penetrating - surgery
Humans
Male
management
Middle Aged
nail gun
Neurology
Occupational Injuries - diagnostic imaging
Occupational Injuries - etiology
Occupational Injuries - surgery
Penetrating head injury
Tomography, X-Ray Computed
trauma
Treatment Outcome
vascular injury
Vascular System Injuries - diagnostic imaging
Vascular System Injuries - etiology
Vascular System Injuries - surgery
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Summary:Our objective is to discuss penetrating head injuries (PHIs) which, although rare, lead to considerable morbidity and mortality. One of the most significant culprits of PHI is the nail gun, which was introduced in 1959 and has gained substantial popularity. We describe our successful strategy for removing an 8-cm nail that penetrated through the orbit and middle cranial fossa, with the tip lodged within the posterior fossa. Vascular imaging and balloon test occlusion are imperative in circumstances where vessel sacrifice is necessary. In addition, positioning of balloons within large vessels that are in close proximity to the penetrating object is necessary to control bleeding that may occur during removal of the object. It is of paramount importance to have a multidisciplinary team participating in the management and eventual removal of foreign objects within the intracranial compartment. Included is a review of the literature and a discussion on management approaches to such injuries.
ISSN:1052-3057
1532-8511
DOI:10.1016/j.jstrokecerebrovasdis.2017.04.004