title: Self-inflicted nail-gun injury with cranial penetration and use of intraoperative computed tomography.
abstract: BACKGROUND
  Management of penetrating cranial trauma remains a high acuity and imaging intense neurosurgical disorder. Imaging of vital structures, including angiography, is typically conducted to understand the proximity of vital structures in comparison to a foreign body and prepare for intraoperative complications such as hemorrhage. Preservation of function following initial injury in cases where minimal neurological deficit exists is essential.
  
  
  METHODS
  Here, we present a case using intraoperative computed tomography to assist in early detection and resolution of hemorrhage in the surgical management of an intact patient with self-inflicted penetrating cranial trauma.
  
  
  CONCLUSIONS
  This method may aid in early detection of hemorrhage and prevention of consequential neurological deterioration or emergent need for secondary surgery.
authors.affiliation: Department of Neurosurgery, Warren Alpert Medical School of Brown University, Providence, Rhode Island 02903, USA.
authors.forename: Joseph A
authors.initials: JA
authors.lastname: Carnevale
authors.affiliation: Department of Neurosurgery, Warren Alpert Medical School of Brown University, Providence, Rhode Island 02903, USA.
authors.forename: John F
authors.initials: JF
authors.lastname: Morrison
authors.affiliation: Department of Neurosurgery, Warren Alpert Medical School of Brown University, Providence, Rhode Island 02903, USA.
authors.forename: David B
authors.initials: DB
authors.lastname: Choi
authors.affiliation: Department of Neurosurgery, Warren Alpert Medical School of Brown University, Providence, Rhode Island 02903, USA.
authors.forename: Petra M
authors.initials: PM
authors.lastname: Klinge
authors.affiliation: Department of Neurosurgery, Warren Alpert Medical School of Brown University, Providence, Rhode Island 02903, USA.
authors.forename: G Rees
authors.initials: GR
authors.lastname: Cosgrove
authors.affiliation: Department of Neurosurgery, Warren Alpert Medical School of Brown University, Providence, Rhode Island 02903, USA.
authors.forename: Adetokunbo A
authors.initials: AA
authors.lastname: Oyelese
keywords: Brain trauma; intraoperative computed tomography; penetrating brain injury; self-harm disorder; self-inflicted injury