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 . 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 . 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.
Cite this paper
Patel, R. , Desai, B. and Gallagher, T. (2013) Brain abscess from halo pin penetration. Case Reports in Clinical Medicine
, 505-507. doi: 10.4236/crcm.2013.29132
 Perry, J. and Nickel, V.L. (1959) Total cervical spine fusion for neck paralysis. The Journal of Bone & Joint Surgery, 41, 37-60.
 Ray, A., Iyer, R.V. and King, A.T. (2006) Cerebral abscess as a delayed complication of halo fixation. Acta Neurochirurgica (Wien), 148, 1015-1016.http://dx.doi.org/10.1007/s00701-006-0799-0
 Cheong, M.L., Chan, C.Y., Saw, L.B. and Kwan, M.K. (2009) Pneumocranium secondary to halo vest pin penetration through enlarged frontal sinus. European Spine Journal, 18, S269-S271.http://dx.doi.org/10.1007/s00586-009-1004-y
 Kingma, R., Peters, J.M. and Coene, L.N. (2006) Intracranial penetration of a halo pin causing an epileptic seizure. The Journal of Bone & Joint Surgery, 88B, 1654-1655.
 Gelalis, I.D., Christoforou, G., et al. (2009) Brain abscess and generalized seizure caused by halo pin intracranial penetration: Case report and review of literature. European Spine Journal, 18, S172-S175.http://dx.doi.org/10.1007/s00586-008-0759-x
 Garfin, S.R., Botte, M.J., Waters, R.L. and Nickel, V.L. (1986) Complications in the use of the halo fixation device. The Journal of Bone & Joint Surgery, 68A, 320-325.
 Quinones-Hinojosa, A., Chi, J.H. and Manley, G.T. (2007) Emergent placement of halo orthosis after a traumatic cervical injury leading to a cerebral abscess. Journal of Trauma, 62, E11-E13. http://dx.doi.org/10.1097/01.ta.0000246938.18656.5d
 Saeed, M.U., Dacuycuy, M.A. and Kennedy, D.J. (2007) Halo pin insertion-associated brain abscess: Case report and review of literature. Spine, 32, E271-E274.http://dx.doi.org/10.1097/01.brs.0000259976.46403.8a
 Papgelopoulos, P.J., Sapkas, G.S., Kateros, K.T., Papdakis, S.A., et al. (2001) Halo pin intracranial penetration and epidural abscess in a patient with a previous cranioplasty: Case report and review of literature. Spine, 26, E463-E467. http://dx.doi.org/10.1097/00007632-200110010-00030
 Rizzolo, S.J., Piazza, M.R., Cotler, J.M., et al. (1993) The effect of torque pressure on halo pin complication rates. Spine, 18, 2163-2166.http://dx.doi.org/10.1097/00007632-199311000-00003
 Pande, K., Basu, S. and Webb, J.K. (1998) Transient brain injury from penetration of the halo pin. Spinal Cord, 36, 732-733. http://dx.doi.org/10.1038/sj.sc.3100586
 Olson, R.S. (1996) Halo skeletal traction pin site care: Toward developing a standard of care. Rehabilitation Nursing, 21, 243-246.
 Victor, D.I., Breshan, M.J. and Keller, R.B. (1973) Brain abscess complicating the use of halo traction. The Journal of Bone & Joint Surgery, 53A, 635-639.
 Rosenblum, D. and Ehrlich, V. (1995) Brain abscess and psychosis as a complication of a halo orthosis. Archives of Physical Medicine and Rehabilitation, 76, 865-867.