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CC BY-NC-ND 4.0 · J Neurol Surg Rep 2022; 83(02): e54-e62
DOI: 10.1055/s-0042-1749650
Case Report

Delayed-Onset Seizures Following Self-Inflicted Nail Gun Injury to the Head: A Case Report and Literature Review

Alexander Hoey
1   Department of Surgery, Medical University of South Carolina, Charleston, South Carolina, United States
,
Christopher Troy
2   Department of Neurosurgery, University of Tennessee Health Science Center, Memphis, Tennessee, United States
,
Wayne Bauerle
3   Department of Research and Innovation, St. Luke's University Health Network, Bethlehem, Pennsylvania, United States
,
Anthony Xia
4   Department of Surgery, St. Luke's University Health Network, Bethlehem, Pennsylvania, United States
,
Brian Hoey
4   Department of Surgery, St. Luke's University Health Network, Bethlehem, Pennsylvania, United States
› Author Affiliations Funding None.
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Abstract

Nail gun use and its associated incidence of injury have continued to increase since it was first introduced in 1959. While most of these injuries involve the extremities, a subset of patients suffer intracranial trauma. The most recent comprehensive review on this particular subject referenced 41 cases and advocated for further discussion regarding proper treatment plans for these individuals. We present the case of a 25-year-old who suffered 35 self-inflicted penetrating head wounds from a nail gun after suffering an amputation injury at his job site. No neurological deficits were present on his arrival to the emergency room. He underwent surgery to treat his arm wound and remove 13 of the 35 nails. The patient was discharged from the hospital on levetiracetam and made a full recovery. Nearly 1 year later, he experienced a seizure at his workplace. However, after resuming his antiepileptic medication, he reports no further complications. This case is distinct for not only being the most nails in a patient's head at presentation, but also following surgery. Utilizing this case, prior review, and 27 subsequent cases, we propose an updated algorithm for diagnosis and treatment of nail-gun-related penetrating head trauma.

Keywords

nail gun - penetrating head trauma - intracranial injury


Publication History

Received: 07 December 2021

Accepted: 29 March 2022

Article published online:
24 June 2022

© 2022. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

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