Prophylactic removal of a migratory missile from the cerebral ventricles: case report.
Childs Nerv Syst
; 40(4): 1307-1310, 2024 Apr.
Article
en En
| MEDLINE
| ID: mdl-38060070
ABSTRACT
BACKGROUND AND IMPORTANCE Nonpowder firearm injuries to the head pose major health risks, with retained fragments potentially causing harmful sequelae that require neurosurgical intervention. CLINICAL PRESENTATION We report the case of 2-year-old girl who sustained an accidental gunshot wound to the head. She sustained a penetrating ballistic intracranial injury caused by a BB shot from a rifle. At presentation, she was neurologically intact with a punctate laceration on her left forehead. Head CT demonstrated a small depressed left frontal skull fracture, a small intracerebral hematoma, and a 5-mm metallic bullet fragment in the deep left frontal lobe near the frontal horn of the left lateral ventricle. She was admitted to the hospital and managed nonoperatively with levetiracetam and intravenous antibiotics, and discharged home in good condition. Follow-up CT in 1 week showed slight migration of the metallic bullet fragment to the left, placing it at the anterior horn of the lateral ventricle. Six weeks later, follow-up CT showed migration of the bullet to the temporal horn of the left lateral ventricle. Intraventricular migration of the bullet raised concern that it could move further to obstruct the foramen of Monro or cerebral aqueduct. Therefore, we removed the bullet through a small left temporal craniotomy with image guidance using a microsurgical approach through a translucent tube. CONCLUSION:
The authors discuss the rationale and technique for removing a nonpowder firearm bullet that has migrated within the cerebral ventricles.Palabras clave
Texto completo:
1
Banco de datos:
MEDLINE
Asunto principal:
Heridas por Arma de Fuego
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Armas de Fuego
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Traumatismos Craneocerebrales
Límite:
Child, preschool
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Female
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Humans
Idioma:
En
Año:
2024
Tipo del documento:
Article