Ekpene Ubong U, Ndafia Ned M, Uduehe Enono E, Udeme Nsese, Usoro Uyi, Barthélemy Ernest J, Nottidge Timothy E
Neurosurgery Division, Department of Surgery, University of Uyo Teaching Hospital, Uyo, Akwa Ibom State, Nigeria.
Department of Anesthesia, University of Uyo Teaching Hospital, Uyo, Akwa Ibom State, Nigeria.
J Neurosurg Case Lessons. 2025 Jun 16;9(24). doi: 10.3171/CASE25103.
Intracranial nail impalement injury is a rare type of low-energy penetrating brain injury resulting from the forceful entry of a nail into the cranial cavity without exiting it. Clinical outcome depends on the number of impaling nails, the depth of penetration, the extent of the primary brain injury, associated vascular injury, and prompt surgical management to limit secondary injuries. The authors report a case and the management outcome in a low-middle-income country.
A 27-year-old man was reportedly found by his relatives on the floor of his room, having generalized tonic-clonic seizures, and was brought to the University of Uyo Teaching Hospital. He was resuscitated, and an urgent cranial CT scan was performed that showed seven fully implanted, nail-shaped foreign bodies. He underwent emergency craniotomy with extraction of seven 3-inch nails. Brisk bleeding encountered from the injured superior sagittal sinus was controlled effectively. In the postoperative period, he developed nail tracks abscesses that were treated with antibiotics for 6 weeks. He had an excellent recovery with no neurological deficit and was discharged home.
Multiple intracranial nail impalement injuries, although life-threatening, can be treated with excellent outcome following prompt treatment, meticulous surgical technique, and appropriate duration of antibiotics. https://thejns.org/doi/10.3171/CASE25103.
颅内钉刺伤是一种罕见的低能量穿透性脑损伤，由钉子强行进入颅腔但未穿出所致。临床结局取决于刺入钉子的数量、穿透深度、原发性脑损伤的程度、相关血管损伤以及为限制继发性损伤而进行的及时手术处理。作者报告了在一个低收入和中等收入国家的一个病例及其治疗结果。
据报道，一名27岁男性被其亲属发现倒在其房间的地板上，出现全身强直阵挛性发作，随后被送往阿约大学教学医院。对他进行了复苏，并紧急进行了头颅CT扫描，结果显示有7个完全植入的钉子状异物。他接受了急诊开颅手术，取出了7根3英寸长的钉子。对上矢状窦损伤处出现的活跃出血进行了有效控制。术后，他出现了钉道脓肿，用抗生素治疗了6周。他恢复良好，没有神经功能缺损，随后出院回家。
多发性颅内钉刺伤虽然危及生命，但通过及时治疗、精细的手术技巧和适当疗程的抗生素治疗，可取得良好的治疗效果。https://thejns.org/doi/10.3171/CASE25103 。
