Migration of the retained intracranial bullet to the spinal canal: A case report

Introduction. Retained intracranial missiles migration is rarely reported. Most of the time, the missile will migrate and remain intracranially, but in extremely rare cases, it may reach the spinal canal. The aim of the study was to present a patient with this rare clinical entity. Case report. The...

Full description

Bibliographic Details
Main Authors: Lepić Milan, Minić Ljubodrag, Stefanović Slaviša, Novaković Nenad, Lokaj Aleksandra, Pavlićević Goran
Format: Article
Language:English
Published: Military Health Department, Ministry of Defance, Serbia 2021-01-01
Series:Vojnosanitetski Pregled
Subjects:
Online Access:http://www.doiserbia.nb.rs/img/doi/0042-8450/2021/0042-84502000033L.pdf
_version_ 1818900133327142912
author Lepić Milan
Minić Ljubodrag
Stefanović Slaviša
Novaković Nenad
Lokaj Aleksandra
Pavlićević Goran
author_facet Lepić Milan
Minić Ljubodrag
Stefanović Slaviša
Novaković Nenad
Lokaj Aleksandra
Pavlićević Goran
author_sort Lepić Milan
collection DOAJ
description Introduction. Retained intracranial missiles migration is rarely reported. Most of the time, the missile will migrate and remain intracranially, but in extremely rare cases, it may reach the spinal canal. The aim of the study was to present a patient with this rare clinical entity. Case report. The 29-years-old male suffered from the gunshot wound to the head through the left external auditory meatus. The bullet was located in the posterior fossa. Initial debridement without bullet removal was performed. Four months after the injury, the patient came back complaining of neck stiffness and progressive weakness of all extremities. Plain radiography revealed the bullet in the spinal canal at the level of C2 vertebra and computed tomography confirmed localization in the posterior aspect. An emergency procedure was performed for bullet removal and spinal cord decompression. Conclusion. The bullets tend to migrate. Migration to the spinal canal is rare, but takes a significant risk, due to the potential secondary injury. The removal of a bullet at-all-costs may not be justified. However, the prediction of migration based on the predisposing factors would be of great value to treating these patients adequately.
first_indexed 2024-12-19T19:59:01Z
format Article
id doaj.art-e3cb6014f1ec4b7fa4de3c512b93003c
institution Directory Open Access Journal
issn 0042-8450
2406-0720
language English
last_indexed 2024-12-19T19:59:01Z
publishDate 2021-01-01
publisher Military Health Department, Ministry of Defance, Serbia
record_format Article
series Vojnosanitetski Pregled
spelling doaj.art-e3cb6014f1ec4b7fa4de3c512b93003c2022-12-21T20:07:44ZengMilitary Health Department, Ministry of Defance, SerbiaVojnosanitetski Pregled0042-84502406-07202021-01-0178101103110710.2298/VSP200315033L0042-84502000033LMigration of the retained intracranial bullet to the spinal canal: A case reportLepić Milan0https://orcid.org/0000-0003-0060-5336Minić Ljubodrag1Stefanović Slaviša2Novaković Nenad3Lokaj Aleksandra4Pavlićević Goran5University of Defence, Faculty of Medicine of the Military Medical Academy, Belgrade, Serbia + Military Medical Academy, Clinic for Neurosurgery, Belgrade, SerbiaUniversity of Defence, Faculty of Medicine of the Military Medical Academy, Belgrade, Serbia + Military Medical Academy, Clinic for Neurosurgery, Belgrade, SerbiaMilitary Medical Academy, Clinic for Neurosurgery, Belgrade, SerbiaUniversity of Defence, Faculty of Medicine of the Military Medical Academy, Belgrade, Serbia + Military Medical Academy, Clinic for Neurosurgery, Belgrade, SerbiaMilitary Medical Academy, Clinic for Neurosurgery, Belgrade, SerbiaUniversity of Defence, Faculty of Medicine of the Military Medical Academy, Belgrade, Serbia + Military Medical Academy, Clinic for Neurosurgery, Belgrade, SerbiaIntroduction. Retained intracranial missiles migration is rarely reported. Most of the time, the missile will migrate and remain intracranially, but in extremely rare cases, it may reach the spinal canal. The aim of the study was to present a patient with this rare clinical entity. Case report. The 29-years-old male suffered from the gunshot wound to the head through the left external auditory meatus. The bullet was located in the posterior fossa. Initial debridement without bullet removal was performed. Four months after the injury, the patient came back complaining of neck stiffness and progressive weakness of all extremities. Plain radiography revealed the bullet in the spinal canal at the level of C2 vertebra and computed tomography confirmed localization in the posterior aspect. An emergency procedure was performed for bullet removal and spinal cord decompression. Conclusion. The bullets tend to migrate. Migration to the spinal canal is rare, but takes a significant risk, due to the potential secondary injury. The removal of a bullet at-all-costs may not be justified. However, the prediction of migration based on the predisposing factors would be of great value to treating these patients adequately.http://www.doiserbia.nb.rs/img/doi/0042-8450/2021/0042-84502000033L.pdfhead injuries, penetratingneurosurgeryspinal cord compression
spellingShingle Lepić Milan
Minić Ljubodrag
Stefanović Slaviša
Novaković Nenad
Lokaj Aleksandra
Pavlićević Goran
Migration of the retained intracranial bullet to the spinal canal: A case report
Vojnosanitetski Pregled
head injuries, penetrating
neurosurgery
spinal cord compression
title Migration of the retained intracranial bullet to the spinal canal: A case report
title_full Migration of the retained intracranial bullet to the spinal canal: A case report
title_fullStr Migration of the retained intracranial bullet to the spinal canal: A case report
title_full_unstemmed Migration of the retained intracranial bullet to the spinal canal: A case report
title_short Migration of the retained intracranial bullet to the spinal canal: A case report
title_sort migration of the retained intracranial bullet to the spinal canal a case report
topic head injuries, penetrating
neurosurgery
spinal cord compression
url http://www.doiserbia.nb.rs/img/doi/0042-8450/2021/0042-84502000033L.pdf
work_keys_str_mv AT lepicmilan migrationoftheretainedintracranialbullettothespinalcanalacasereport
AT minicljubodrag migrationoftheretainedintracranialbullettothespinalcanalacasereport
AT stefanovicslavisa migrationoftheretainedintracranialbullettothespinalcanalacasereport
AT novakovicnenad migrationoftheretainedintracranialbullettothespinalcanalacasereport
AT lokajaleksandra migrationoftheretainedintracranialbullettothespinalcanalacasereport
AT pavlicevicgoran migrationoftheretainedintracranialbullettothespinalcanalacasereport