title: Self-inflicted penetrating head injury in a patient with manic-depressive disorder.
abstract: A 32-year-old Caucasian male with a history of repeated self-injury drilled a hole in his skull using a power tool and subsequently introduced intracerebrally a binding wire from a sketch pad. An emergency craniotomy was performed around the site of cranial injury, and the foreign body was carefully extracted. The wire was located partially in the subdural space and partially in the right hemisphere of the brain. The patient made an excellent recovery and was referred to a psychiatrist for further treatment. This is a rare case of unusual and complex repetitive self-destructive behavior without apparent suicidal intent. The pertinent literature is reviewed and the surgical and psychiatric implications of such injuries are discussed.
authors.affiliation: Department of Neurosurgery, the Walton Centre for Neurology and Neurosurgery NHS Trust, Liverpool, United Kingdom.
authors.forename: Konstantina
authors.initials: K
authors.lastname: Karabatsou
authors.forename: Jothy
authors.initials: J
authors.lastname: Kandasamy
authors.forename: Jothy
authors.initials: J
authors.lastname: Kandasami
authors.forename: Nikolai G
authors.initials: NG
authors.lastname: Rainov
mesh_terms: D000328:Adult; D001714:Bipolar Disorder / Q000523:psychology*; D003399:Craniotomy; D005547:Foreign Bodies / Q000473:pathology* / Q000601:surgery; D020197:Head Injuries, Penetrating / Q000473:pathology*; D006801:Humans; D008297:Male; D016728:Self-Injurious Behavior / Q000473:pathology / Q000523:psychology*