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Case Reports
. 2024 Jan 9;16(1):e51974.
doi: 10.7759/cureus.51974. eCollection 2024 Jan.

A Nail in the Brain

Tze Huei Kee  1 , Khoo Chung Lee  1 , Adlina Abdul Rahim  1 , Noor Khairul Binti Rasid  1
Affiliations
Case Reports

A Nail in the Brain

Tze Huei Kee et al. Cureus. .

Abstract

Transorbital penetrating brain injuries (TOPI) are rare. We report a case of industrial injury that resulted in perforating eye injury and intracranial foreign body by a nail gun. A 30-year-old man accidentally fired a nail gun onto his left eye at his construction workplace while handling the malfunctioned equipment and sustained a perforating injury of the left eye with intracranial foreign body. The misfired nail was lodged in his frontal lobe of the brain. He also suffered laceration wounds of the lateral canthus of the left eye and fractures of the left orbital floor and roof. He underwent emergency bicoronal craniotomy and removal of intracranial foreign body, followed by left eye examination under anaesthesia as well as scleral toilet and suturing. The nail was successfully removed. He recovered well with no neurological deficit and was discharged on postoperative day 5 with a Glasgow Coma Scale score of 15; however, his left eye vision remained no perception of light. Work-related eye injuries can be debilitating and are largely preventable.

Keywords: industrial injury; intracranial foreign body; nail gun; perforating eye injury; transorbital.

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Conflict of interest statement

The authors have declared that no competing interests exist.

Figures

Figure 1
Figure 1. Picture of the patient’s left eye at presentation showing lacerated lateral canthus, prolapse of the uveal tissues, extensive subconjunctival hemorrhage, chemosis, and total hyphema.
Figure 2
Figure 2. Plain X-ray of the skull, anteroposterior (A) and lateral (B) views, showing a metallic foreign body resembling a nail.
Figure 3
Figure 3. Non-contrasted CT brain (coronal view) showing the nail (A) and fractures of the left orbital roof and floor (B).
Figure 4
Figure 4. A three-dimensional reconstructed CT of the brain showing the nail penetrated in the left orbital roof and lodged in the frontal lobes.
See this image and copyright information in PMC

References

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