Article Text

Download PDFPDF
Traumatic intracranial nail-gun injury of the right internal carotid artery causing pseudoaneurysm and caroticocavernous fistula
  1. Christopher Alan Brooks1,2,3,4,
  2. Ashraf Dower3,5,
  3. Andrew Bonura6,7,8,
  4. Nathan Manning9,10 and
  5. James Van Gelder1,2,3,4
  1. 1The School of Medicine, The University of Sydney, Sydney, New South Wales, Australia
  2. 2Neurosurgery, Concord Repatriation General Hospital, Sydney, New South Wales, Australia
  3. 3Neurosurgery, Liverpool Hospital, Sydney, New South Wales, Australia
  4. 4The Sydney Spine Institute, Sydney, New South Wales, Australia
  5. 5Neurosurgery, Westmead Hospital, Sydney, New South Wales, Australia
  6. 6Radiology, Liverpool Hospital, Sydney, New South Wales, Australia
  7. 7Radiology, Campbelltown Hospital, Campbelltown, New South Wales, Australia
  8. 8The School of Medicine, Western Sydney University, Sydney, New South Wales, Australia
  9. 9Interventional Radiology, Liverpool Hospital, Sydney, New South Wales, Australia
  10. 10The Ingham Institute, Sydney, New South Wales, Australia
  1. Correspondence to Dr. Christopher Alan Brooks; brooks.christopher.alan{at}gmail.com

Abstract

Penetrating trauma due to nail gun is an uncommon yet important clinical entity. There are numerous case reports describing these injuries, yet few describe those resulting in cerebrovascular injury. Laceration of cerebral blood vessels may result in significant intracranial haemorrhage and cerebral ischaemia, with catastrophic consequences. In the present study, we report a female patient who was shot in the face with a nail gun in a domestic assault. The nail entered her right cavernous sinus and lacerated her right internal carotid artery causing a pseudoaneurysm and a caroticocavernous fistula. This report details the approach to, and pitfalls of, managing a cerebrovascular injury due to penetrating intracranial nail. Catheter cerebral angiography is essential in the diagnosis and treatment of these injuries. Best treatment and outcomes require clinicians with expertise in endovascular and surgical repair strategies.

  • neurological injury
  • trauma CNS /PNS
  • neurosurgery

Statistics from Altmetric.com

Footnotes

  • Contributors CAB wrote the project manuscript. AD assisted with editing and discussion points. AB assisted with image selection and description. NM and JVG supervised the project.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer-reviewed.

Request Permissions

If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.