Abstract
BACKGROUND AND IMPORTANCE: Pneumatic nail guns are a rare cause of penetrating brain injury, and subsequent nail removal in the acute setting is well reported. However, reports of late removal or removal of nails adjacent to intracranial vessels are rare. In the delayed setting, scar formation around the nails and surrounding brain structures may complicate surgical removal. Here, we report a case of late removal of brain-penetrating nails adherent to the middle cerebral artery branches. CLINICAL PRESENTATION: A 70-year-old left-handed male presented with mild aphasia, vertigo, and facial nerve palsy. Imaging studies demonstrated two nails fired 2 months before in the right temporal lobe adjacent to the middle cerebral artery branches. The nails were surgically removed through a modified pterional approach after meticulous dissection of scar tissue adherent to the nails. Before removal, proximal vessel control was achieved. CONCLUSION: Brain-penetrating nail removal weeks after the original incident may be complicated by extensive scarring. This can be dealt with a generous craniotomy, proximal vessel control through microsurgical or endovascular means, and careful dissection of scar tissue around the nails.
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
