Management of a Low-Energy Penetrating Brain Injury Caused by a Nail

Ferraz, Vinicius Ricieri; Aguiar, Guilherme Brasileiro de; Araújo, João Luiz Vitorino; Badke, Guilherme Lellis; Veiga, José Carlos Esteves

doi:10.1155/2016/4371367

Cited by 13 publications

(17 citation statements)

References 11 publications

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“…Although blind retrieval can be used to remove nails with heads outside of the skull, 17 , 27 , 28 complications, including delayed ICH, have been reported in several studies. 17 , 27 – 31 Therefore, craniotomy is strongly recommended for debridement and hematoma examination in cases of embedded nails.…”

Section: Discussionmentioning

confidence: 99%

Survival after multiple nail gun injuries to the brain, lung, and heart: a case report and a review of the literature

et al. 2021

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Most nail gun injuries involve the extremities and result from work-related accidents. Injuries to the brain or thorax are relatively rare, and cases with injuries to both regions are even rarer and often lethal. Initial evaluation, resuscitation, and surgical planning can be challenging for emergency physicians and surgeons. We present the details of a man with multiple nail gun injuries to the brain, lung, and heart following a suicide attempt. The patient presented to the emergency department in shock. After immediate resuscitation, emergent sternotomy, and subsequent craniotomy, he was discharged without significant morbidity. According to the literature, this is the only reported case involving multiple nail gun injuries to the brain, lungs, and heart. The mortality rate of multiple nail gun injuries involving the head and chest is approximately 20%. Rapid evaluation, immediate resuscitation, and appropriate imaging and surgery are crucial for increasing survival and achieving a good prognosis. Emergency sternotomy for cardiac injury is the foremost priority, and the timing of craniotomy depends on the patient’s vital sign status and whether brain injury is evident. A preprint of this article is available online: DOI: 10.21203/rs.3.rs-35448/v1.

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Section: Discussionmentioning

confidence: 99%

Survival after multiple nail gun injuries to the brain, lung, and heart: a case report and a review of the literature

et al. 2021

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“…Head CT scans clearly showed that no important functional areas or structures were damaged; neuroimaging is crucial in any penetrating head injury. [ 12 ]…”

Section: Discussionmentioning

confidence: 99%

Diagnosis and treatment of a penetrating brain injury caused by a welding electrode

Shi¹,

Sun²,

Chen

et al. 2019

Medicine

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Rationale:Penetrating brain injury caused by a welding electrode is a rare occurrence. This type of injury requires careful preoperative assessment and timely treatment measures to avoid secondary damage.Patient concerns:A 55-year-old male patient fell from a height of approximately 5 m during when a welding electrode in his left hand was inadvertently inserted into his brain. The patient had a GCS score of 15 and complaints of dizziness and headache. CT showed an object of metallic density penetrating the skull and entering the brain parenchyma in the frontotemporal region.Diagnosis:According to the clinical findings and preoperative imaging examination, the diagnosis was open craniocerebral injury with intracranial foreign body and left orbital wall fracture.Intervention:After definite diagnosis and sufficient preoperative preparation, active surgical treatment was carried out to remove intracranial foreign body. Anti-infection and other symptomatic treatment were given after operation. The signs of infection and changes of vital signs were closely observed.Outcomes:After treatment, no obvious adverse reactions were found and the patient was discharged. No complications such as infection occurred during the follow-up period of 6 months.Lessons:In treating patient with a welding electrode penetrating the brain, assessments need to be made preoperatively, the welding electrode needs to be removed in a timely manner, complete hemostasis needs to be achieved during surgery with total repair of the damaged area, and anti-inflammatory treatment needs to be administered postoperatively to achieve good results.

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“…Neurosurgical treatment performed by craniotomy still seems to be the safest one; there are reports of complications such as subdural hematoma and intraparenchymal haemorrhages following the blind removal of foreign bodies leading to suggestions that all penetrating foreign bodies should be removed under direct vision. 3 Prognosis of patients with penetrating injuries to the brain generated by objects with low kinetic energy is good and they have a better outcome. After taking informed written consent, patient was shifted to the neurosurgical operating room Standard American Society of Anaesthesiologists (ASA) monitors were attached and baseline vitals were recorded.…”

Section: Pathological Discussionmentioning

confidence: 99%