Removal of nail penetrating the basilar artery.
Nail-gun injuries have become an increasingly prevalent source of penetrating intracranial trauma. Few cases of intracranial nail-gun injuries disturbing major cerebrovascular structures have been reported, and none entailing basilar artery involvement. We report here the case of a 51-year-old male with an intracranial nail-gun injury involving penetration of the distal basilar artery. Operative removal was accomplished under direct vision using a double concentric cranioorbital zygomatic osteotomy for a trans-Sylvian approach. We highlight the principles involved in removing foreign bodies penetrating critical neurovascular structures.
Neurovascular Section, Department of Neurosurgery, Yale University School of Medicine, New Haven, CT 06520, USA.
Dario J
DJ
Englot
Maxwell S
MS
Laurans
Khalid
K
Abbed
Ketan R
KR
Bulsara
D001488:Basilar Artery / Q000000981:diagnostic imaging / Q000293:injuries*; D001777:Blood Coagulation; D002533:Cerebral Angiography; D002543:Cerebral Hemorrhage / Q000209:etiology / Q000601:surgery; D003252:Construction Materials; D003866:Depressive Disorder / Q000523:psychology; D005547:Foreign Bodies / Q000000981:diagnostic imaging / Q000601:surgery*; D020197:Head Injuries, Penetrating / Q000000981:diagnostic imaging / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D019635:Neurosurgical Procedures; D009915:Orbit / Q000601:surgery; D010027:Osteotomy; D013406:Suicide, Attempted; D014057:Tomography, X-Ray Computed; D015050:Zygoma / Q000601:surgery