Not your first choice of painkiller

I’ve just found this alarming case study [pdf] from the Singapore Medical Journal about a patient who had a nail banged into their head by a local healer in an attempt to treat persistent headaches.

Craniocerebral penetrating wounds caused by nails are rare and reported as curious experiences. A 45-year-old female patient presented with a metal nail in situ in the middle of her head, very close to the right side of the midline. The patient had been unconscious since the time of injury. There was no history of vomiting or seizures. Neurologically, the eye opening and verbal response were nil, but she was localised to the pain and moved all four limbs equally. The pupils were bilaterally symmetrical and reactive to light. General and systemic examinations were unremarkable.

The relatives revealed that she had been suffering from a headache (more on the right side) for the last ten years, with off and on exacerbation. They took the patient to a Tantrik, who hammered the nail into her head to get rid of the bad omen. Anteroposterior and lateral radiographs of the skull showed a foreign object inside the skull, very near to the midline. As there were no facilities to perform computed tomography (CT) in the peripheral hospital, the nail was removed under local anaesthesia, based on the radiographical findings. After the removal of the nail, she was managed conservatively and made a gradual recovery in her sensorium. The patient was doing well at follow-up.

As medical historian Owsei Temkin discussed in his definitive book on the history of epilepsy The Falling Sickness (ISBN 0801848490) banging nails into the head was also a Roman ‘treatment’ for seizures.

Link to PubMed entry for case study.
pdf of full text of case study.