Winder Mark J, Monteith Stephen J, Lightfoot Nicholas, Mee Edward
Department of Neurosurgery, Auckland City Hospital and Starship Children's Hospital, The University of Auckland, Auckland, New Zealand.
J Clin Neurosci. 2008 Jan;15(1):18-25. doi: 10.1016/j.jocn.2007.06.020. Epub 2007 Nov 26.
Penetrating head injury from nailguns has become increasingly recognised due to their frequent use in the construction industry and home. We report a New Zealand case series of 12 penetrating nailgun head injuries, the largest of its type, detailing presentation, management, risk factors and outcomes. Recommendations based on these factors are provided, suggesting a minimal surgical approach and an individually case-assessed need for antibiotic prophylaxis and anti-epileptic drugs. Prognostic factors on initial imaging are discussed. The majority of injuries, despite being visually impressive, are associated with minimal neurological impairment.