For the curious (something we always encourage here at IFLScience), there are few places better to look for interesting stories than the Case Reports section of a medical journal. Whether it's the tale of an 8-centimeter (3.1-inch) live worm being pulled from a woman's brain, or a whole new reason to be frightened of sneezing, the annals of medical science can often be stranger than fiction. Such is the case with a new report, about a man who got off comparatively lightly when a malfunctioning nail gun shot a nail straight through his eye and into his brain.
A note of caution before we begin: the images in the paper linked at the end of this article are not for the squeamish.
The report, written by the patient’s medical team at Hospital Sultanah Bahiyah in Malaysia, describes how the 30-year-old had been working on a construction site, operating a pneumatic nail gun without wearing safety goggles. The gun had jammed, and when the man had checked the barrel for malfunctions, it had accidentally discharged into his left eye.
Upon arrival at the hospital, the man was described as being “cooperative and fully oriented” despite his significant wounds, which is more than could be said for some of us if we were in his position. There was very extensive damage and bleeding in his left eye, and he had vision loss on that side. However, it soon became clear that the problems went far beyond his eye.
An X-ray of the man’s skull showed that the nail had penetrated the frontal lobe of his brain, fracturing his eye socket as it went, with evidence of bleeding extending into neighboring brain regions.
The patient underwent emergency surgery to remove the nail, during which the surgeons were able to confirm that the major arteries and the olfactory nerves had thankfully escaped injury. They were also able to go some way to repair the damage to his eye, after which the patient spent some time in intensive care.
“He recovered well during his postoperative period with no neurological deficit,” the team wrote, going on to explain that he was discharged after just five days in hospital. While he was undeniably lucky to not experience any brain damage from the incident, the team did confirm that the man’s vision had unfortunately not returned at their last follow-up a week later. It’s unclear how the man fared after that, since he returned to his home country shortly afterward to continue treatment there.
These types of injuries, called transorbital-penetrating intracranial injuries (TOPI), are thankfully rare, but they have a high mortality rate. When talking about workplace injuries more generally, the US Bureau of Labor Statistics reported that 18,510 workers experienced eye injuries in 2020 alone, of which just over a third were damage to the eye from foreign objects or equipment.
The authors concluded that this case should serve as a warning about the importance of proper safety procedures in the workplace, emphasizing the need for employers to provide adequate protective equipment to prevent injuries.
From the man who was burned by his high-vis jacket to the welder who ended up with an earful of molten steel, there’s no shortage of workplace accidents in the medical literature. But if you’re tempted to cry off in favor of a day in bed, you might want to familiarize yourself with some of the hazards that can befall you in there too…
The study (which contains graphic images) is published in the journal Cureus.