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Pneumatic drill through the foramen magnum
  1. ANDREW W MCEVOY,
  2. NIGEL D MENDOZA
  1. West London Neurosciences Centre, Charing Cross Hospital, Fulham Palace Road, London, UK
  1. Dr Andrew W McEvoy, West London Neurosciences Centre, Charing Cross Hospital, Fulham Palace Road, London W6 8RF, UK.

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A 29 year old man fell off a ladder while operating a power drill on a building site. The drill became embedded in the patient’s face and was still rotating under power when his workmates reached him. The patient was attended by the air ambulance, ventilated, and taken to the casualty department, were the above lateral skull x ray (figure (A)) and CT (figure (B)) were performed. The drill bit entered the face opposite the left lower second premolar tooth, then continued medially, superiorly, and posteriorly to traverse the oropharynx, pass superiorly to the arch of the atlas, through the foramen magnum, crossing the medulla and lower pons, terminating in the right cerebellar hemisphere. The drill bit was removed under sedation. The patient has survived, although he remains tetraplegic. He is able to communicate via a series of blinking movements.

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