TITLE:
Brain abscess from halo pin penetration
AUTHORS:
Rohit Patel, Bobby K. Desai, T. James Gallagher
KEYWORDS:
Cerebral Abscess; Cranial Pin; Halo Orthosis Device; Inner Table of Skull; Complication
JOURNAL NAME:
Case Reports in Clinical Medicine,
Vol.2 No.9,
December
12,
2013
ABSTRACT:
Halo fixation devices
are often employed for critically ill or trauma patients with unstable cervical
pathologies. These include fractures, spinal decompression and reconstruction
procedures. However, the critical care literature has surprisingly little
information in regard to associated complications. Perry and Nickel pioneered
the initial halo device in 1959 and soon afterward recognized complications
associated with its use [1]. They developed a detailed regimen to prevent
abnormal pin placement and infections. The details include pin placement in
“safe” zones, specific degrees of torque, and techniques to minimize infection
risk. Despite a low death rate, a cerebral brain abscess often leads to prolonged
neurological morbidity [2]. Seizures and pneumocranium have also been ascribed
to intracranial penetration of halo pins [3,4]. The following describes a
patient with cerebral abscess secondary to halo pin penetration. He then
developed several other associated complications during hospitalization.