title: Multiple self-inflicted nail gun head injury.
abstract: Penetrating brain injury resulting from nail-gun use is a well-characterized entity, one that is increasing in frequency as nail guns become more powerful and more readily available to the public. We present a case and offer management strategies for a 50-year-old male with two intracranial penetrating nail gun injuries. Nail gun brain injuries are commonly intentionally self-inflicted. Suicide should be considered when straight nails cause wounds to the chest, head, or abdomen. The primary preoperative concern is formation of a traumatic pseudoaneurism, which prompts both preoperative and follow-up cerebral angiography. Surgery for combined intracranial and extracranial injury may require the collaborative expertise of colleagues from the fields of ophthalmology, otolaryngology, and oral maxillofacial surgery. A rational management strategy should permit these patients to be discharged with no additional injury.
authors.affiliation: Wellmont Holston Valley Medical Center Trauma Center, Department of Surgery, East Tennessee State University College of Medicine, Kingsport, TN 37660, USA. gmt0@charter.net
authors.forename: George M
authors.initials: GM
authors.lastname: Testerman
authors.forename: Laura M
authors.initials: LM
authors.lastname: Dacks
mesh_terms: D001921:Brain; D002533:Cerebral Angiography; D003399:Craniotomy; D005547:Foreign Bodies / Q000000981:diagnostic imaging / Q000601:surgery; D020197:Head Injuries, Penetrating / Q000000981:diagnostic imaging / Q000601:surgery; D006801:Humans; D008297:Male; D008875:Middle Aged; D013406:Suicide, Attempted