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Neurosurg Rev. 2010 Oct;33(4):501-4. doi: 10.1007/s10143-010-0268-3. Epub 2010 Jun 8.

Removal of nail penetrating the basilar artery.

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  • 1Neurovascular Section, Department of Neurosurgery, Yale University School of Medicine, New Haven, CT 06520, USA.


Nail-gun injuries have become an increasingly prevalent source of penetrating intracranial trauma. Few cases of intracranial nail-gun injuries disturbing major cerebrovascular structures have been reported, and none entailing basilar artery involvement. We report here the case of a 51-year-old male with an intracranial nail-gun injury involving penetration of the distal basilar artery. Operative removal was accomplished under direct vision using a double concentric cranioorbital zygomatic osteotomy for a trans-Sylvian approach. We highlight the principles involved in removing foreign bodies penetrating critical neurovascular structures.

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