A case of multiple nail gun injuries to the head and one to the heart

BACKGROUND: Nail gun injuries, while uncommon, can present significant treatment challenges. Many are often caused by work-related accidents, they have also been seen in suicide attempts and assaults. CASE DESCRIPTION: A 53-year-old male was transferred from a peripheral hospital to a tertiary center after being found confused and with a left-sided weakness. Initial scans showed four nails penetrating the skull, with one additional nail in the pericardium. These all underwent surgical removal, and due to meticulous pre- and perioperative planning, the patient had a largely uneventful recovery. CONCLUSION: The challenging nature of these injuries requires extensive workup prior to surgical decision-making in order to minimize potential complications.