Thursday, April 27, 2006

Man With 12 Nails in Head Survives

PORTLAND — A 33-year-old Oregon man on methamphetamine and suffering from mental health problems fired 12 nails from a nail gun into his head and survived.

The man, who has not been identified by medical officials for privacy reasons, went to an Oregon hospital last year complaining of a headache.

Doctors were surprised when they took X-rays and found the nails - six clustered between his right eye and ear, two below his right ear and four on the left side of his head.

No one before is known to have survived having intentionally fired so many foreign objects into the head, according to the current issue of the Journal of Neurosurgery, where the case is detailed.

The nails were not visible when doctors initially examined the man in the emergency room of a hospital, a day after he'd fired the nail gun. When doctors saw the X-ray results, they transferred him to Oregon Health & Science University in Portland for intensive neurological care.

He became short-tempered and hostile when OHSU staff asked him how the injury occurred, according to the study. Psychological examinations showed he had "poor judgment and insight."

The man at first told doctors he had had a "nail gun accident." It wasn't until later that the patient admitted he'd used meth and the injury was a suicide attempt.

The patient was in remarkably good condition when he got to OHSU, according to the study. While even one nail to the head can be fatal, these nails came close to major blood vessels and the brain stem but did not pierce either.

The nails still posed a threat to the patient's health and doctors decided to operate quickly. Because of the number of nails, doctors decided to fully sedate him rather than keep him partially awake, which is done in some surgeries to monitor neurological responses.

Surgeons were able to remove the nails with needle-nosed pliers and a drill because the nail heads did not penetrate the skull.

The patient was later transferred to psychiatric care. He stayed there nearly a month until a court-ordered hospital stay expired. Then the patient left, against medical advice, the study said.

Nail gun injuries are often accidental. But over 65 percent of the time, a nail gun injury to the head is associated with an intentional discharge, a psychiatric disorder or both, the study said.

This patient suffered from an undiagnosed mood disorder with suicidal intent, the study said.

He told doctors that he later attempted suicide again but has been drug-free for six months and has been able to recover.

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MM

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