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Head Trauma From a Nail Gun
IMAGES
Head Trauma From a Nail Gun
Author: Sally Bragg, RN, MSN, CCRC, Hollywood, Fla
Sally Bragg is Health Profession Education Coordinator, Center for Bioterrorism and All-Hazards Preparedness, Nova Southeastern University, Fort Lauderdale, Fla. For correspondence, write: Sally Bragg, RN, MSN, CCRC, Center for Bioterrorism and All-Hazards Preparedness, Nova Southeastern University, 3200 S. University Dr., Fort Lauderdale-Davie, FL 33328; E-mail: [email protected]. J Emerg Nurs 2006;32:329. 0099-1767/$32.00 Copyright n 2006 by the Emergency Nurses Association. doi: 10.1016/j.jen.2006.05.005
A
28-year-old man arrived at the trauma bay after a roofing project accident in which a nail from a nail gun embedded in the patient’s parietal vertex. He was stable on admission with no loss of consciousness or neurologic compromise. A computerized tomography scan of his head and venogram of his brain confirmed the location of the nail, approximately two-thirds of the distance between the anterior and posterior sinus, with possible sinus injury. He had no hematoma, skull fracture, or hemorrhage. Even though nail-gun injuries cause less damage and have a better prognosis than cerebral gun shot injury, intracranial infection and vascular compromise can be lethal complications.1 This patient required an open craniotomy for possible sinus repair, debridement of the brain, and nail removal because this f lathead, roofing nail was barbed and approximately 2.5 cm in length. The gravity of the procedure is demonstrated by the risk of serious bleeding or major neurologic compromise from possible sagittal sinus thrombosis or contusion. The patient was stable throughout the procedure, he received perioperative intravenous antibiotics, and subsequently he was discharged without any complications.
REFERENCE 1. Shibuya T, Kushi H, Miyagi A, Miyagami M, Tsubokawa T. [A case of penetrating head injury caused by nail-gun]. No Shinkei Geka 1993;21:373-7.
August 2006
32:4
JOURNAL OF EMERGENCY NURSING
329
Head Trauma From a Nail Gun
Author: Sally Bragg, RN, MSN, CCRC, Hollywood, Fla
Sally Bragg is Health Profession Education Coordinator, Center for Bioterrorism and All-Hazards Preparedness, Nova Southeastern University, Fort Lauderdale, Fla. For correspondence, write: Sally Bragg, RN, MSN, CCRC, Center for Bioterrorism and All-Hazards Preparedness, Nova Southeastern University, 3200 S. University Dr., Fort Lauderdale-Davie, FL 33328; E-mail: [email protected]. J Emerg Nurs 2006;32:329. 0099-1767/$32.00 Copyright n 2006 by the Emergency Nurses Association. doi: 10.1016/j.jen.2006.05.005
A
28-year-old man arrived at the trauma bay after a roofing project accident in which a nail from a nail gun embedded in the patient’s parietal vertex. He was stable on admission with no loss of consciousness or neurologic compromise. A computerized tomography scan of his head and venogram of his brain confirmed the location of the nail, approximately two-thirds of the distance between the anterior and posterior sinus, with possible sinus injury. He had no hematoma, skull fracture, or hemorrhage. Even though nail-gun injuries cause less damage and have a better prognosis than cerebral gun shot injury, intracranial infection and vascular compromise can be lethal complications.1 This patient required an open craniotomy for possible sinus repair, debridement of the brain, and nail removal because this f lathead, roofing nail was barbed and approximately 2.5 cm in length. The gravity of the procedure is demonstrated by the risk of serious bleeding or major neurologic compromise from possible sagittal sinus thrombosis or contusion. The patient was stable throughout the procedure, he received perioperative intravenous antibiotics, and subsequently he was discharged without any complications.
REFERENCE 1. Shibuya T, Kushi H, Miyagi A, Miyagami M, Tsubokawa T. [A case of penetrating head injury caused by nail-gun]. No Shinkei Geka 1993;21:373-7.
August 2006
32:4
JOURNAL OF EMERGENCY NURSING
329