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Nail impalement: Treating an impaled brain

Someone suffering from a brain injury is a serious concern for patients, families and doctors alike. The type of brain injury suffered can help indicate the kind of recovery a patient could face, but finding that a patient has been impaled by a nail or other sharp object can be devastating. Nail impalement, or any other type of sharp impalement to the brain, is a neurosurgical emergency. The swelling this causes could lead to brain damage and symptoms like memory loss or paralysis; some patients will die, and others may remain in a coma or other vegetative state, requiring families to seek out compensation for rising medical costs.

A nail injury to the brain typically occurs because of a nail gun misfiring or a person falling onto one. Sometimes, it's a criminal act that leads to the injury. In a car accident, flying debris and the impact of the other vehicle could force objects into someone's skull.

Surgical extraction is necessary when any kind of item enters the brain through the skull; these injuries tend to be low-velocity injuries, so the patient's prognosis is likely to be good. If the tip of the nail, the head, is visible, it may be possible to remove it blind, although surgery is typically recommended in order to prevent secondary injuries or various complications, such as infection.

Some patients who have this kind of injury may have limited pain; they could suffer a headache or some weakness without many other side effects. However, bleeding on the brain and swelling can lead to additional damage.

Source: US National Library of Medicine, "Management of a nail impalement injury to the brain in a non-neurosurgical centre: A case report and review of the literature," Chika Thaddeus Agu and Mathew Emeka Orijaku, accessed June 09, 2016

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