ECT in an Elderly Patient with Skull Defects and Shrapnel

Electroconvulsive therapy (ECT) was successfully used to treat a patient with large neurosurgical defects of the cranium and small pieces of shrapnel in the zygoma and neck. Other patients with a variety of skull defects have also been treated successfully. Theoretical considerations of current pathway in ECT would suggest an alteration through the brain when the skull is deformed, but this does not appear to affect clinical outcome.