Management of a nail impalement injury to the brain in a non-neurosurgical centre: A case report and review of the literature

Agu, Chika Thaddeus; Orjiaku, Mathew Emeka

doi:10.1016/j.ijscr.2015.12.035

Cited by 18 publications

(15 citation statements)

References 11 publications

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“…As seen in the indexed patient, the penetrating object did not cause intracranial bleeding at the time of TBI occurs due to a tamponade effect. Haemorrhage tends to occur once the tamponade effect ceases to act during surgical extraction of the foreign object [18]. Minimal blood lot was observed in the present case.…”

Section: Discussionsupporting

confidence: 46%

Anesthetic Management of a Rare Penetrating Traumatic Brain Injury Caused by a Pickaxe: A Case Report

Mbengono¹,

Ntock²,

Tochie³

et al. 2019

OJAnes

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Penetrating traumatic brain injuries (TBI) are frequent neurosurgical emergencies, associated with a high mortality rate and we almost no previous report on a penetrating pickaxe TBI. Herein, we report and discuss the anesthetic challenges encountered in the surgical extraction of a pickaxe from a patient with TBI. We present the case of a 34-year-old man who presented with a penetrating pickaxe TBI at his left temporal region, signs of raised intracranial pressure and normal vital signs. Anesthetic management began within 3 hours of admission and consisted of general anesthesia and rapid sequence intubation. Surgical extraction of a 14 cm long wing of the pickaxe was achieved with good hemostatic control. His postoperative course was marked by complete blindness of the right eye till one year of follow-up. The authors highlight the need of a prompt multidisciplinary management with close perioperative monitoring of haemostatic control and signs of raised intracranial pressure as key factors for a favourable postoperative outcome.

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Section: Discussionsupporting

confidence: 46%

Anesthetic Management of a Rare Penetrating Traumatic Brain Injury Caused by a Pickaxe: A Case Report

Mbengono¹,

Ntock²,

Tochie³

et al. 2019

OJAnes

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“…The most common cause of nail gun injury is work related accidents; other causes result from accidental firing of a nail gun, suicide attempts by firing nail guns into the brain, and bomb blasts containing pieces of nails. Except for the bomb blast, the prognosis of patients with nail injuries to the brain is good and they have a better outcome than the gunshot injuries by the fact that these lesions caused by nails are generated by low energetic kinetic mechanisms [ 1 , 2 ].…”

Section: Introductionmentioning

confidence: 99%

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

Ferraz

Aguiar

Araújo

et al. 2016

Case Reports in Neurological Medicine

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Low-energy penetrating nail injury to the brain is an extremely rare neurosurgical emergency. The most common cause of nail gun injury is work related accidents; other causes result from accidental firing of a nail gun, suicide attempts by firing nail guns into the brain, and bomb blasts containing pieces of nails. Neurosurgical treatment performed by craniotomy still seems to be the safest one; there are reports of complications such as subdural hematoma and intraparenchymal hemorrhages following the blind removal of foreign bodies leading to suggestions that all penetrating foreign bodies should be removed under direct vision. We report a rarely described neurosurgical approach for removal of a penetrating nail from the brain and skull without evidence of associated hematoma and other brain lesions.

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“…But they may bleed once that tamponade effect ceases to act i.e. during their extraction [6]. The visible nail head in our patient guided the surgeons in the successful extraction.…”

Section: Discussionmentioning

confidence: 69%