CASE REPORT
A case of self-inflicted craniocerebral penetrating injury
Emergency Department, Mayday University Hospital, Croydon, London, UK
Correspondence to:
Correspondence to:
C J Blakeley
Emergency Department, Mayday University Hospital, Croydon, London, UK; christopher.blakeley@mayday.nhs.uk
Accepted 29 November 2005
Keywords: craniocerebral; nail
| The first 150 words of the full text of this article appear below. |
A 44 year old man was referred to the accident and emergency department by the psychiatric services, having claimed to have hammered several nails through his skull over a three month period. The patient had a long history of depression, personality disorder, and previous deliberate self-harm. He had remained well throughout this period and had been cleaning the wounds with weak antiseptic on a regular basis. He had concealed the injuries by wearing a hat. Two days prior to admission he had inserted a much larger 12.7 cm (5 inch) masonry nail and had developed left sided weakness and unsteadiness of gait.
Examination showed that the patient remained well with no evidence of infection in the central nervous system. Neurological examination revealed a mild left sided weakness (4/5 Medical Research Council (MRC) scale) affecting both the arm and leg. The patient was fully alert and orientated and conversed normally. Inspection
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