The patient is a 49 year old male who tried to commit suicide by nailing three large nails into his head.  This patient was picked up by the California Highway Patrol for speeding and brought in to the Emergency Room with a "splitting headache" and seizures.  Skull x rays reveals three 3 inch nails embedded into the patients skull and brain. He was taken to the operating room where he underwent removal of two nails by two separate supratentorial craniotomies. He was then turned into the prone position on the Mayfield headholder to undergo a third posterior fossa craniotomy for nail removal. He underwent successful removal of all three nails and had a full post operative recovery with resolution of all seizure activity and return to normal activities.