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Unusual craniocerebral injuries from nailing
Surgical Neurology
|November 1, 1980
Summary
Unusual craniocerebral injuries from self-inflicted nail insertions into the parietal area were documented. Most patients had minimal pain and easy nail extraction, but one died from meningitis after losing consciousness.
Area of Science:
- Neurology
- Trauma Surgery
- Forensic Pathology
Background:
- Self-inflicted craniocerebral injuries are rare but present unique diagnostic and management challenges.
- Nail-related head trauma is an uncommon mechanism of injury, often associated with specific psychological factors.
Observation:
- Three cases of deliberate nail insertion into the parietal region of the skull are presented.
- Nails, approximately 10 cm long, were midline or paramidline in location.
- Two patients reported minimal pain and maintained consciousness, with easy nail extraction.
Findings:
- The severity of injury did not correlate with reported pain or consciousness level.
- The patient who died presented with coma and developed meningitis, suggesting a severe intracranial complication.
- Easy nail extraction in most cases indicates a lack of significant initial bony fragmentation or dural penetration.
Implications:
- Highlights the importance of thorough neurological assessment in cases of penetrating head trauma, regardless of initial presentation.
- Suggests that even seemingly minor penetrating injuries can lead to severe complications like meningitis.
- Underscores the need for multidisciplinary management, including neurosurgical intervention and infectious disease consultation, for such unusual injuries.