Boy's skull pierced with screw in treehouse-building accident

A Salisbury boy survived a freak accident that left a 6-inch screw in his skull — a mishap that required delicate neurosurgery at Johns Hopkins Hospital.

The good news is that Darius Foreman was able to go home on Thursday, his 13th birthday.

“They were so nice at the hospital,” said his mother, Joy Ellingsworth. “They threw him a party and decorated the room while he was asleep.”

Darius, a seventh-grader at Wicomico Middle School, was at his aunt’s house in Parsonsburg building a treehouse in the unseasonably warm weather on Jan. 20 when he fell from a branch. As he landed, a 5-foot-long board with a large construction screw fell on top of his head, piercing his skull and his brain.

At first, Darius wasn’t sure what happened.

“I thought something was stuck in my hair,” he said Friday.

But his two cousins immediately ran to get their mother, Bobbi Burke. She found Darius wandering around the yard with the board stuck to his head, and made him lie down while she called 911, Ellingsworth said.

Burke’s next call was to Ellingsworth.

“It was instant dread,” she said when she got the news.

Paramedics from the Parsonsburg Volunteer Fire Company were able to cut part of the board in order to fit him into an ambulance and take him to Peninsula Regional Medical Center in Salisbury, Maryland. Doctors there X-rayed his brain and decided to send him on to Johns Hopkins in Baltimore, Ellingsworth said.

Because of the board that was still attached to Darius’ head, he could not fit inside a standard helicopter, so the hospital called Maryland State Police, who have a larger one.

In the emergency room at Hopkins, Dr. Shenandoah Robinson, a neurosurgeon, was able to remove the rest of the board that was still attached to Darius’ head. Next the boy was sent into surgery for a procedure that took about two hours.

“The danger was where it was located,” said Dr. Alan R. Cohen, chief of pediatric neurosurgery at Hopkins.

Scans of Darius’ brain showed what looked like the screw going right into the superior sagittal sinus, the large pipeline vein that drains the blood from the brain to the heart. 

“That’s what made this injury so serious — that fact that he could have exsanguinated (suffered major bleeding),” Cohen said.

Cohen said because of the screw’s location, it was “like a ticking time bomb.”

“We went slowly and carefully, and we managed to get the thing out,” he said.

The surgical team also removed a small blood clot that had formed, then placed a titanium plate in his skull. Darius was kept in the hospital for several days afterward to administer antibiotics following surgery.

He will continue to be on intravenous antibiotics for another week at home, Elligsworth said. Otherwise he is in good shape.

“He’s a lucky guy,” Cohen said.

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