Department of Neurology, Gyeongsang National University School of Medicine, Jinju, Korea.
Psychiatry Investig. 2011 Sep;8(3):272-4. doi: 10.4306/pi.2011.8.3.272. Epub 2011 Jul 19.
The self-infliction of foreign bodies into the brain represents rare a clinical phenomenon that has been reported primarily in cases involving accidents and suicide attempts. However, various motivations for self-injurious behaviors as well as suicide attempts have been reported, especially in patients with psychotic illnesses. A 47-year-old man with a history of schizophrenia presented to our hospital due to the presence of a nail on his plain skull X-ray. He diagnosed paranoid type of schizophrenia about 17 years earlier, and his psychiatric symptoms were well controlled by medication. Interestingly, he was not aware of the presence of the nail in his brain and showed no neurological deficits. In the course of detailed history taking, we discovered that the nail was driven into his brain during a hallucinatory experience that had occurred more than 10 years earlier. Because we believed that removing the nail from his brain would be more dangerous than maintaining the status quo, the nail was not removed. This is a very rare case of a self-inflicted injury involving inserting a nail into the brain under the influence of hallucinations. The absence of adverse effects or neurological symptoms/signs related to the presence of a foreign metallic body in the brain for over 10 years is exceptional.
将异物自行植入大脑是一种罕见的临床现象，主要见于意外事故和自杀企图的病例中。然而，也有各种自残行为和自杀企图的动机被报道，尤其是在精神病患者中。一名 47 岁男子，既往有精神分裂症病史，因平片颅骨 X 线检查发现有指甲而就诊于我院。他在 17 年前被诊断为偏执型精神分裂症，其精神病症状通过药物治疗得到了很好的控制。有趣的是，他不知道自己的大脑中有钉子，也没有出现神经功能缺损。在详细的病史询问过程中，我们发现这颗钉子是在 10 多年前的一次幻觉体验中被钉入大脑的。由于我们认为从他的大脑中取出钉子会比维持现状更危险，所以没有取出钉子。这是一个非常罕见的案例，涉及在幻觉的影响下将钉子自行植入大脑。在大脑中存在异物（金属）超过 10 年而没有出现与异物相关的不良影响或神经症状/体征的情况是异常的。
