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Visual Disturbance Caused by a Nail Gun-Induced Penetrating Brain Injury

  • Ye, Jin Bong (Trauma Center, Chungbuk National University Hospital) ;
  • Sul, Young Hoon (Trauma Center, Chungbuk National University Hospital) ;
  • Kim, Se Heon (Trauma Center, Chungbuk National University Hospital) ;
  • Lee, Jin Young (Trauma Center, Chungbuk National University Hospital) ;
  • Lee, Jin Suk (Trauma Center, Chungbuk National University Hospital) ;
  • Kim, Hong Rye (Trauma Center, Chungbuk National University Hospital) ;
  • Yoon, Soo Young (Trauma Center, Chungbuk National University Hospital) ;
  • Choi, Jung Hee (Trauma Center, Chungbuk National University Hospital)
  • Received : 2021.03.16
  • Accepted : 2021.06.02
  • Published : 2021.09.30

Abstract

Penetrating brain injury caused by a nail gun is an uncommon clinical scenario reported in the literature. A 36-year-old male presented with a nail that had penetrated through the occipital bone. He was alert and neurologically intact except for visual disturbance. Computed tomography (CT) of the brain showed the nail lodged at the occipital lobe and the parietal lobe, with minimal intracerebral hemorrhage. The nail was placed in the occipital lobe close to the superior sagittal sinus. We removed the nail with craniotomy since the entrance of the nail was close to the superior sagittal sinus. There were no newly developed neurological deficits postoperatively. Immediate postoperative CT showed no newly developed lesions. The patient recovered well without any significant complications. Two weeks postoperatively, magnetic resonance imaging showed no remarkable lesions. The visual disturbance was followed up at the outpatient department. To summarize, we report a rare case of penetrating head injury by a nail gun and discuss relevant aspects of the clinical management.

Keywords

References

  1. Woodall MN, Alleyne CH Jr. Nail-gun head trauma: a comprehensive review of the literature. J Trauma Acute Care Surg 2012;73:993-6. https://doi.org/10.1097/TA.0b013e318256df41
  2. Shakir A, Koehler SA, Wecht CH. A review of nail gun suicides and an atypical case report. J Forensic Sci 2003;48:409-13.
  3. Centers for Disease Control and Prevention (CDC). Nail-gun injuries treated in emergency departments--United States, 2001-2005. MMWR Morb Mortal Wkly Rep 2007;56:329-32.
  4. Jeon YH, Kim DM, Kim SH, Kim SW. Serious penetrating craniocerebral injury caused by a nail gun. J Korean Neurosurg Soc 2014;56:537-9. https://doi.org/10.3340/jkns.2014.56.6.537
  5. Oh HH, Kim Y, Park SC, Ha YS, Lee KC. Nail gun induced open head injury: a case report. Korean J Neurotrauma 2014;10:139-41. https://doi.org/10.13004/kjnt.2014.10.2.139
  6. Litvack ZN, Hunt MA, Weinstein JS, West GA. Self-inflicted nail-gun injury with 12 cranial penetrations and associated cerebral trauma. Case report and review of the literature. J Neurosurg 2006;104:828-34. https://doi.org/10.3171/jns.2006.104.5.828
  7. Makoshi Z, AlKherayf F, Da Silva V, Lesiuk H. Nail gun injuries to the head with minimal neurological consequences: a case series. J Med Case Rep 2016;10:58. https://doi.org/10.1186/s13256-016-0839-1
  8. Sani S, Jobe KW, Byrne RW. Successful repair of an intracranial nail-gun injury involving the parietal region and the superior sagittal sinus. Case report. J Neurosurg 2005;103:567-9. https://doi.org/10.3171/jns.2005.103.3.0567
  9. Blankenship BA, Baxter AB, McKahn GM 2nd. Delayed cerebral artery pseudoaneurysm after nail gun injury. AJR Am J Roentgenol 1999;172:541-2. https://doi.org/10.2214/ajr.172.2.9930820
  10. Kazim SF, Shamim MS, Tahir MZ, Enam SA, Waheed S. Management of penetrating brain injury. J Emerg Trauma Shock 2011;4:395-402. https://doi.org/10.4103/0974-2700.83871
  11. Antibiotic prophylaxis for penetrating brain injury. J Trauma 2001;51(Suppl 2):S34-40. https://doi.org/10.1097/00005373-200108001-00009
  12. Bayston R, de Louvois J, Brown EM, Johnston RA, Lees P, Pople IK. Use of antibiotics in penetrating craniocerebral injuries. "Infection in neurosurgery" Working Party of British Society for Antimicrobial Chemotherapy. Lancet 2000;355:1813-7. https://doi.org/10.1016/S0140-6736(00)02275-3
  13. Aarabi B, Taghipour M, Haghnegahdar A, Farokhi M, Mobley L. Prognostic factors in the occurrence of posttraumatic epilepsy after penetrating head injury suffered during military service. Neurosurg Focus 2000;8:e1.
  14. Antiseizure prophylaxis for penetrating brain injury. J Trauma 2001;51(Suppl S):S41-3. https://doi.org/10.1097/00005373-200108001-00010
  15. 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:e143-9. https://doi.org/10.1016/j.jstrokecerebrovasdis.2016.09.001
  16. Spennato P, Bocchetti A, Mirone G, Savarese L, Squillante D, Rotondo M, et al. Double concentric craniotomy for a craniocerebral penetrating nail. Case report and technical note. Surg Neurol 2005;64:368-71; discussion 371. https://doi.org/10.1016/j.surneu.2004.12.003
  17. Savino PJ, Glaser JS, Schatz NJ. Traumatic chiasmal syndrome. Neurology 1980;30:963-70. https://doi.org/10.1212/WNL.30.9.963
  18. Bruce BB, Zhang X, Kedar S, Newman NJ, Biousse V. Traumatic homonymous hemianopia. J Neurol Neurosurg Psychiatry 2006;77:986-8. https://doi.org/10.1136/jnnp.2006.088799