Self-inflicted nail-gun injury with cranial penetration and use of intraoperative computed tomography

Surg Neurol Int. 2016 May 6;7(Suppl 10):S259-62. doi: 10.4103/2152-7806.181980. eCollection 2016.

Abstract

Background: Management of penetrating cranial trauma remains a high acuity and imaging intense neurosurgical disorder. Imaging of vital structures, including angiography, is typically conducted to understand the proximity of vital structures in comparison to a foreign body and prepare for intraoperative complications such as hemorrhage. Preservation of function following initial injury in cases where minimal neurological deficit exists is essential.

Case description: Here, we present a case using intraoperative computed tomography to assist in early detection and resolution of hemorrhage in the surgical management of an intact patient with self-inflicted penetrating cranial trauma.

Conclusions: This method may aid in early detection of hemorrhage and prevention of consequential neurological deterioration or emergent need for secondary surgery.

Keywords: Brain trauma; intraoperative computed tomography; penetrating brain injury; self-harm disorder; self-inflicted injury.