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

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 Garrido^I; Frederico Figueiredo Amâncio^II; Rodrigo Moreira Faleiro^III; Geraldo Magela Ribeiro^IV; Thiago Cardoso Vale^V

^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}

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