So, how’d he not know there was a nail in his brain?

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Dante Autullo, 32, of Orland Park, talks Friday at Christ Medical Center in Oak Lawn about accidentally shooting a nail into his brain. | Brett Roseman~Sun-Times Media

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• Man who shot nail into his brain thought X-ray was a ‘doctor joke’

Updated: February 23, 2012 8:15AM

For more than 24 hours, Dante Autullo had a 3 1/2-inch nail embedded in his brain and didn’t know it.

How can that be? The answer’s not a brain teaser, just a lesson in anatomy.

“The brain itself does not perceive pain or feel it,” said Dr. Martin G. Luken III, the medical director of neurosurgery at Ingalls Memorial Hospital in Harvey.

Autullo, 32, of Orland Park, accidentally shot himself in the back of the head with a nail gun Tuesday morning while working in his garage. He and his fiancee, Gail Glaenzer, thought his injury was just a laceration and that the nail had whizzed past his ear. But he felt nauseous Wednesday, and a CAT scan revealed the nail’s presence.

Christ Medical Center neurosurgeon Dr. Leslie Schaffer removed it Thursday during a two-hour procedure.

Schaffer said that to remove the nail without damaging the brain, he made a circular incision around the nail’s entry point. He peeled off the skin, then punched two holes in the skull. Using a type of saw, he cut around the two holes. He then lifted out the piece of skull that still held the embedded nail.

When he saw the brain was not bleeding — bleeding would indicate potential future problems, like a loss of motor skills or memory function — he patched up the hole with mesh and a titanium plate.

Luken also has done such surgical procedures. He recently treated a patient who got into a fight at a bar and a gun went off. The man picked himself up, dusted himself off and went home without giving it a second thought.

“Several hours later he didn’t feel right,” Luken said. “He came in and, lo and behold, he had a bullet in his head.”

Luken said it was likely Autullo survived his incident because the nail was thin and fired at a low velocity. The nail also didn’t cause any infection in the brain.

“His guardian angel is on duty,” Luken said.

That Autullo suffered what Luken called a “penetrating brain injury” to the back of the brain might have made all of the difference, too. Autullo might be a complete different person if the nail struck him in the brain’s frontal lobe.

Luken pointed to the famous but tragic medical case of Vermont laborer Phineas Gage. Gage was working on a railroad site in 1848 when a freak explosion blasted a tamping iron through the front of his brain. He lived for another 12 years.

“He survived but his personality was completely changed,” Luken said. “He never was right after that and he had all sorts of trouble with mood and that kind of thing.”

Luken said the front of the brain controls emotion while the back, where Autullo suffered his injury, controls the body’s machinery — movement, vision, feeling.