IMAGES IN NEUROLOGY
Cervical gunshot wound: bullet trajectory on three-dimensional computed tomography scan
Ferimento por arma de fogo em região cervical: trajetória da bala na tomografia computadorizada tri-dimensional
Juliana Cabrera GarridoI; Frederico Figueiredo AmâncioII; Rodrigo Moreira FaleiroIII; Geraldo Magela RibeiroIV; Thiago Cardoso ValeV
IMD, Internal Medicine Resident at Hospital João XXIII, Fundação Hospitalar do Estado de Minas Gerais, Belo Horizonte MG, Brazil
IIMD, Intensivist at Hospital João XXIII, Fundação Hospitalar do Estado de Minas Gerais, Belo Horizonte MG, Brazil
IIIMD, Neurosurgeon, Head of the Residency Program of Neurosurgery at Hospital João XXIII, Fundação Hospitalar do Estado de Minas Gerais, Belo Horizonte MG, Brazil
IVMD, Radiologist at Hospital João XXIII, Fundação Hospitalar do Estado de Minas Gerais, Belo Horizonte MG, Brazil
VMD, Neurologist at Hospital das Clínicas, Universidade Federal de Minas Gerais, Belo Horizonte MG, Brasil
Correspondence Correspondence: Frederico Figueiredo Amâncio Hospital João XXIII, Fundação Hospitalar do Estado de Minas Gerais Avenida Professor Alfredo Balena, 400 30130-100 Belo Horizonte MG - Brasil E-mail: manzoff@gmail.com
An 18-year-old man was admitted to the Emergency Unit shortly after having a gunshot wound in the neck. The patient developed an acute flaccid tetraplegia combined with arreflexia and sphincter impairment. He was promptly intubated and immobilized with a cervical spine collar. Three-dimensional (3D) cervical computed tomography (CT) scan showed the bullet trajectory with entrance on the right side and no exit on the left side (Figure). A C4-C5 bone fracture was observed, as well as right jugular vein thrombosis. All the greater cervical arteries were incredibly spared. Three-dimensional CT scan imaging techniques can be a useful tool for evaluating gunshot wounds of the cervical region1.
Received 27 February 2012
Received in final form 11 June 2012
Accepted 28 June 2012
Conflict of interest: There is no conflict of interest to declare.
- 1. Bruner D, Gustafson CG, Visintainer C. Ballistic injuries in the emergency department. Emerg Med Pract 2011;13:1-30.
Publication Dates
-
Publication in this collection
14 Nov 2012 -
Date of issue
Nov 2012