Brain abscess from halo pin penetration

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.