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Emergency casebook

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A case of self-inflicted craniocerebral penetrating injury

▸ A 44 year old man was referred to the emergency department by the psychiatric services having claimed to have hammered several nails through his skull over a 3 month period. The patient remained well throughout this period and had been cleaning the wounds with weak antiseptic on a regular basis. Two days prior to admission the patient had inserted a much larger 5 inch masonry nail and had developed left sided weakness and unsteadiness of gait. The patient was fully alert and orientated and conversed normally. Inspection of the scalp revealed a large masonry nail protruding from the scalp with several …

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