• George M Testerman and Laura M Dacks.
• Wellmont Holston Valley Medical Center Trauma Center, Department of Surgery, East Tennessee State University College of Medicine, Kingsport, TN 37660, USA. gmt0@charter.net
• South. Med. J. 2007 Jun 1; 100 (6): 608-10.

AbstractPenetrating brain injury resulting from nail-gun use is a well-characterized entity, one that is increasing in frequency as nail guns become more powerful and more readily available to the public. We present a case and offer management strategies for a 50-year-old male with two intracranial penetrating nail gun injuries. Nail gun brain injuries are commonly intentionally self-inflicted. Suicide should be considered when straight nails cause wounds to the chest, head, or abdomen. The primary preoperative concern is formation of a traumatic pseudoaneurism, which prompts both preoperative and follow-up cerebral angiography. Surgery for combined intracranial and extracranial injury may require the collaborative expertise of colleagues from the fields of ophthalmology, otolaryngology, and oral maxillofacial surgery. A rational management strategy should permit these patients to be discharged with no additional injury.

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