Freak accident leaves a 3-inch nail lodged in a child's brain
Key Takeaways
Industry Buzz
“Pediatric neurotrauma is chaos in slow-motion. The window for intervention is tight because anything over 2 hours from injury to operating room increases the risk of intracranial swelling and irreversible damage. In rural or resource-limited settings, those delays can make this kind of accident fatal.” — Kiara DeWitt, RN, CPN, pediatric neurosurgery nurse and lead clinical educator for the neurosurgery and neurology unit at Cook Children’s Medical Center, Fort Worth, TX
“Timing is critical, but so is precision. We don’t rush to the operating room without understanding what’s at stake.” — Ronald Benitez, MD, FACS, FAANS, neurosurgeon and specialist in cerebrovascular and neurotrauma surgery, Atlantic Brain and Spine
A 7-year-old child in India was playing when he accidentally fell, landing on a nearly 3-inch-long nail that pierced his neck and got lodged in his brain.[] The child was rushed to a nearby hospital on May 16, 2025, before being transferred to King George's Medical University (KGMU) in Lucknow, India.
The child survived the traumatic accident. According to reports, MRI imaging showed the nail entered from the lower part of the child’s neck and jaw and extended into his skull—the nail just narrowly missed a blood vessel.
The difficult surgery took 4 hours. Afterward, the child was transferred to KGMU’s Pediatric Intensive Care Unit, where he continued his recovery.
Neurologists react
“Penetrating head injuries like this are rare but incredibly time-sensitive,” Ronald Benitez, MD, FACS, FAANS, a board-certified neurosurgeon and specialist in cerebrovascular and neurotrauma surgery at Atlantic Brain and Spine, tells MDLinx.
The first step? “When a patient presents with a foreign object lodged in the head or neck, the first priority is stabilization and imaging—typically a CT scan—to evaluate the object’s trajectory, involvement of vascular structures, and extent of brain injury,” Dr. Benitez says.
He adds that prematurely removing objects like these or not having a clear surgical plan could be fatal. “Neurosurgeons work closely with trauma and emergency room teams to design a controlled surgical approach. If major vessels are at risk, angiography or intraoperative neuro-navigation may be required,” he says.
"Timing is critical, but so is precision. We don’t rush to the operating room without understanding what’s at stake."
— Ronald Benitez, MD, FACS, FAANS
Inside the lifesaving surgery
For patients undergoing these surgeries, there are major risks, like hemorrhage, infection, stroke, or damage to critical brain regions, Dr. Benitez says.
There’s good news, however: “With modern imaging and microsurgical tools, survival is possible, even in cases that initially seem catastrophic,” he adds. “This case underscores the importance of coordination across emergency care, radiology, and neurosurgery, and why strong systems of care and rapid response protocols are essential in neurotrauma management.”
Kiara DeWitt, RN, CPN, a pediatric neurosurgery nurse and lead clinical educator for the neurosurgery and neurology unit at Cook Children’s Medical Center in Fort Worth, TX, says the consequences depend on what the nail could have hit: “If it narrowly dodged vascular structures and stayed extradural, the child might walk out of that ICU in 2 weeks. If it missed the circle of Willis, the brainstem, and the major sinuses, [he could] walk out with deficits as low as 15%. But if it grazes the medulla or hits the sagittal sinus, you are fighting for ventilation and long-term cognitive viability.”
Timing is everything
She adds that the child’s survival was likely due to fairly quick access to proper hospitalization: “Pediatric neurotrauma is chaos in slow-motion. The window for intervention is tight because anything over 2 hours from injury to operating room increases the risk of intracranial swelling and irreversible damage. In rural or resource-limited settings, those delays can make this kind of accident fatal.”
The good news, she says, is that kids are tough: “Pediatric brains bounce back more than adult ones, thanks to plasticity. But they still need exact timing, a flawless plan, and zero surprises in the OR.”
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