A fatal case due to a pitchfork penetrating head injury

Penetrating head injuries can be the result of numerous intentional or unintentional events, including missile wounds, stab wounds, and motor vehicle or occupational accidents (nails, screwdrivers). The most common wound is a knife injury, although bizarre craniocerebral-perforating injuries have been reported that were caused by nails, metal poles, ice picks, keys, pencils, chopsticks, and power drills. Here is presented the case of a farmer wounded with a pitchfork. In a country area in the South of Italy, a 56-year-old Caucasian farmer was found unresponsive from his father-in-law, few meters before their farmland, with a tine of the pitchfork penetrated in the right eye. He was quickly taken by helicopter to the nearest hospital in serious clinical condition and immediately accepted in the Intensive Care Unit. Glasgow Coma Scale score was 3. In the right eye, was detected a penetrating circular wound. The cranium CT showed a large haemorrhagic area in the right frontal-temporal-parietal lobe, hemoventricle and right to left brain shift; in right occipital region was present radiological evidence of subarachnoid hemorrhage and fractures of lateral wall of orbital bone. Neurosurgical treatment was performed for subarachnoid hemorrhage, but four days after the penetrating stab trauma, the man was pronounced dead.