Related Experiment Video
Updated: Feb 17, 2026
Surgical Induction of Endolymphatic Hydrops by Obliteration of the Endolymphatic Duct
Published on: January 22, 2010
Self-Inflicted Drywall Screws in the Sagittal Sinus
1Department of Neurosurgery, Kaiser Permanente/University of California San Francisco, Sacramento, California, USA.
Abstract:
A 30-year-old right-handed man with a history of schizophrenia presented with 2 self-inflicted drywall screws in the skull. The patient was sleepy but easily arousable; blood tests showed he had taken methamphetamines. Computed tomography and computed tomography angiography of the head showed the frontal screw abutted left of the superior sagittal sinus, and the posterior screw went through the superior sagittal sinus with no extravasation of contrast material at either site. Both screws were removed with exposure of the sagittal sinus using U-shaped craniectomies. There was no bleeding on the removal of the screws. It appears the posterior screw entered between the leaflets of the sagittal sinus dura mater. The patient had returned to work without any sequelae 1 month after injury.
Insights
A man with schizophrenia self-inflicted skull injuries with drywall screws. Both screws were successfully removed without complications, and the patient recovered fully, highlighting the potential for good outcomes even with severe penetrating head trauma.
Area of Science:
- Neurosurgery
- Trauma Surgery
- Psychiatry
Background:
- A 30-year-old male with a history of schizophrenia presented with two self-inflicted drywall screws embedded in his skull.
- The patient had also ingested methamphetamines, as indicated by blood tests.
Observation:
- Computed tomography (CT) and CT angiography revealed the screws' positions: one near the superior sagittal sinus, the other penetrating it.
- Crucially, no contrast extravasation was observed at either screw site, suggesting intact dural venous sinus integrity despite penetration.
Findings:
- Screws were surgically removed via U-shaped craniectomies with direct exposure of the superior sagittal sinus.
- No intraoperative or postoperative bleeding occurred during or after screw removal.
- Histopathological analysis suggested the posterior screw may have entered between the dural leaflets of the superior sagittal sinus.
Implications:
- This case demonstrates successful surgical management of penetrating intracranial trauma involving the superior sagittal sinus.
- It highlights the importance of prompt surgical intervention and meticulous technique in managing such complex injuries.
- The patient's complete recovery underscores the potential for favorable outcomes in selected cases of self-inflicted penetrating head trauma.
Related Concept Videos
01:22Sutures of the Skull
Sutures are immobile joints between adjacent bones of the skull. The narrow gap between the bones is filled with dense, fibrous connective tissue that unites the bones. The long sutures located between the skull bones are not straight but instead follow irregular, tightly twisting paths. These twisting lines tightly...
01:27Cranial Bones: Lateral View
The temporal bone forms the lower lateral side of the skull. The temporal bone is subdivided into several regions. The flattened upper portion is the squamous portion of the temporal bone. Below this area and projecting anteriorly is the zygomatic process of the temporal bone, which forms the posterior portion of the zygomatic arch. Posteriorly is the mastoid portion of the temporal bone. Projecting...