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A case of self-inflicted craniocerebral penetrating injury
  1. G James,
  2. C J Blakeley,
  3. K Hashemi,
  4. K Channing,
  5. M Duff
  1. Emergency Department, Mayday University Hospital, Croydon, London, UK
  1. Correspondence to:
 C J Blakeley
 Emergency Department, Mayday University Hospital, Croydon, London, UK; christopher.blakeley{at}mayday.nhs.uk

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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 …

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