title: Disabling Orthostatic Headache after Penetrating Stonemason Pencil Injury to the Sacral Region.
abstract: Penetrating injuries to the spine, although less common than motor vehicle accidents and falls, are important causes of injury to the spinal cord. They are essentially of two varieties: gunshot or stab wounds. Gunshot injuries to the spine are more commonly described. Stab wounds are usually inflicted by knife or other sharp objects. Rarer objects causing incidental spinal injuries include glass fragments, wood pieces, chopsticks, nailguns, and injection needles. Just few cases of penetrating vertebral injuries caused by pencil are described. The current case concerns a 42-year-old man with an accidental penetrating stonemason pencil injury into the vertebral canal without neurological deficit. After the self-removal of the foreign object the patient complained of a disabling orthostatic headache. The early identification and treatment of the intracranial hypotension due to the posttraumatic cerebrospinal fluid (CSF) sacral fistulae were mandatory to avoid further neurological complications. In the current literature acute pattern of intracranial hypotension immediately after a penetrating injury of the vertebral column has never been reported.
authors.affiliation: Department of Neurosurgery, Pope John XXIII Hospital, OMS Square No. 1, 24100 Bergamo, Italy.
authors.forename: Carlo
authors.initials: C
authors.lastname: Brembilla
authors.affiliation: Department of Neurosurgery, Pope John XXIII Hospital, OMS Square No. 1, 24100 Bergamo, Italy.
authors.forename: Luigi Andrea
authors.initials: LA
authors.lastname: Lanterna
authors.affiliation: Department of Anesthesia and Intensive Care, Pope John XXIII Hospital, OMS Square No. 1, 24100 Bergamo, Italy.
authors.forename: Paolo
authors.initials: P
authors.lastname: Gritti
authors.affiliation: Department of Neurosurgery, Pope John XXIII Hospital, OMS Square No. 1, 24100 Bergamo, Italy.
authors.forename: Emanuele
authors.initials: E
authors.lastname: Costi
authors.affiliation: Department of Neurosurgery, Pope John XXIII Hospital, OMS Square No. 1, 24100 Bergamo, Italy.
authors.forename: Gianluigi
authors.initials: G
authors.lastname: Dorelli
authors.affiliation: Department of Neurosurgery, Pope John XXIII Hospital, OMS Square No. 1, 24100 Bergamo, Italy.
authors.forename: Elena
authors.initials: E
authors.lastname: Moretti
authors.affiliation: Department of Neurosurgery, Pope John XXIII Hospital, OMS Square No. 1, 24100 Bergamo, Italy.
authors.forename: Claudio
authors.initials: C
authors.lastname: Bernucci