Down the barrel of a nail gun

The ANZ Journal of Surgery just published the summary of a conference paper describing 12 patients with head injuries caused by nail guns. It makes for some surprising reading.

You might think brain injuries from nail guns would be rare, but there are a startling number of case studies in the medical literature.

A recent review of suicide attempts by nail gun noted it was unusual, but this new case series suggests that many of this type of brain injury are caused in this way.

In fact, out of the 12 cases, three quarters were attempting to kill themselves.

Mostly, the cases concern a single nail, but one case was particularly extreme:

The other case involved a staggering 24 nails of 5cm length and represents the largest number of intra-cranial nails in a surviving patient.

This beats the previous record of 12 nails, held by a man reported in a case study from a neurosurgery team in Portland, Oregon.

The picture is the X-ray of Isidro Mejia, who survived a nail gun accident in 2004, where he was unfortunate enough to have four nails embedded in his skull and two in his neck.

Removal of a nail often involves a craniotomy, where the surgeons have to cut around the bit of skull where the nail is embedded, and remove it in one piece.

There are some images of this operation in an article from the Spanish language neurosurgery journal Neurocirugía which is available online as a pdf.

Link to abstract of nail gun head injury case series.
pdf of Spanish language case report of neurosurgical nail removal.

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