PT  - JOURNAL ARTICLE
AU  - Alexander W. Glover
AU  - Rasheed Zakaria
AU  - Paul May
AU  - Chris Barrett
TI  - Overtightening of halo pins resulting in intracranial penetration, pneumocephalus, and epileptic seizure
AID  - 10.1016/j.ijsp.2013.01.004
DP  - 2013 Jan 01
TA  - International Journal of Spine Surgery
PG  - e42--e44
VI  - 7
4099  - http://ijssurgery.com//content/7/e42.short
4100  - http://ijssurgery.com//content/7/e42.full
SO  - Int J Spine Surg2013 Jan 01; 7
AB  - A 60-year-old man sustained an undisplaced type III odontoid fracture following a fall down a full flight of stairs. His medical history was remarkable for a partial pancreatectomy and splenectomy in 2006 for chronic pancreatitis. This had rendered him diabetic, on insulin, and he required long-term administration of penicillin V.The fracture was treated with a halo vest, and, unknowing of its potentially serious consequences, the patient continued to tighten the halo pins himself.He presented 1 month later following a witnessed seizure. A computed tomography scan was performed, which demonstrated 2 cranial perforations, with the halo pins penetrating the cranium and resultant pneumocephalus.He was started on antiepileptic medication and was placed in a pinless halo system. He had no further seizures and has made an uneventful neurological recovery. This paper serves to highlight the potential complications which may arise from the use of a halo vest. Proper patient education is essential to avoid these serious yet avoidable events, and patients with low bone density and the immunosuppressed should be monitored closely.