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Delayed Cauda Equina syndrome due to a migratory bullet
Shiraz Ahmed Ghori1, Muhammad Shahzeb Khan2, Faizan Imran Bawany2
1Department of Neurosurgery, Dow University of Health Sciences (DUHS), Civil Hospital, Karachi.
Journal of the College of Physicians and Surgeons--Pakistan : JCPSP
|December 19, 2014
Summary
Delayed presentation of Cauda Equina syndrome due to a migrating bullet highlights the need for vigilant follow-up after gunshot injuries. Prompt surgical decompression is crucial for improving neurological deficits.
Area of Science:
- Neurosurgery
- Traumatology
- Spinal Cord Injury
Background:
- Gunshot injuries to the spine can lead to delayed neurological complications.
- Bullet migration within the spinal canal is a rare but serious concern.
Observation:
- A 35-year-old male presented with Cauda Equina syndrome 15 months after a gunshot injury.
- Initial presentation lacked neurological deficits, but later developed urinary and fecal incontinence.
Findings:
- Lumbosacral X-ray revealed a bullet at the L5-S1 level.
- Surgical decompression under fluoroscopic guidance led to improvement in neurological deficits.
Implications:
- Regular follow-up imaging is essential to detect migrating bullets after spinal gunshot injuries.
- Timely surgical intervention for Cauda Equina syndrome is critical for patient recovery.