Citation

Awori J, Wilkinson DA, Gemmete JJ, Thompson BG, Chaudhary N, Pandey AS. J. Stroke Cerebrovasc. Dis. 2017; 26(8): e143-e149.

Affiliation

Department of Neurosurgery, University of Michigan, Ann Arbor, Michigan. Electronic address: adityap@med.umich.edu.

Copyright

(Copyright © 2017, National Stroke Association (U.S.A.), Publisher Elsevier Publishing)

DOI

10.1016/j.jstrokecerebrovasdis.2017.04.004

PMID

28551290

Abstract

Our objective is to discuss penetrating head injuries (PHIs) which, although rare, lead to considerable morbidity and mortality. One of the most significant culprits of PHI is the nail gun, which was introduced in 1959 and has gained substantial popularity. We describe our successful strategy for removing an 8-cm nail that penetrated through the orbit and middle cranial fossa, with the tip lodged within the posterior fossa. Vascular imaging and balloon test occlusion are imperative in circumstances where vessel sacrifice is necessary. In addition, positioning of balloons within large vessels that are in close proximity to the penetrating object is necessary to control bleeding that may occur during removal of the object. It is of paramount importance to have a multidisciplinary team participating in the management and eventual removal of foreign objects within the intracranial compartment. Included is a review of the literature and a discussion on management approaches to such injuries.

Copyright © 2017 National Stroke Association. Published by Elsevier Inc. All rights reserved.

Language: en

Keywords

Penetrating head injury; management; nail gun; trauma; vascular injury