Self-inflicted penetrating brain injury by an iron rod in a psychiatric patient: Case report and literature review

In day to day clinical practice, closed brain injuries outnumber penetrating brain injuries (PBIs). Although PBIs can happen in industrial accidents, car accidents, fall accidents or criminal activities, it is rare to see such episodes in civilian practice. An interesting case of self-inflicted PBI by an iron rod in a psychiatric patient is being reported here. An iron rod approximately 15 cm long was driven inside the brain in an attempt to commit suicide by a 24-year-old female schizophrenic patient. After investigating the patient by plain X-ray and computed tomography (CT) scan, she was operated by the neurosurgical team and the rod was removed successfully. The post-operative period was uneventful. She was given medical and psychiatric care along with psychological counselling in post-operative phase. The principles of management of PBI with particular importance of suicide precaution in psychiatric patients are briefly reviewed in this paper.