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Retained intraspinal bullet--an illustrative case report
Neurosurgical Review
|January 1, 1989
Summary
A bullet lodged in the cervical spine caused increasing pain and neurological symptoms in a patient with tetraplegia. Chronic inflammation from bullet metal breakdown products is suspected as the cause.
Area of Science:
- Neurosurgery
- Neurology
- Radiology
Background:
- A 35-year-old male sustained a gunshot injury resulting in a C5 spinal cord lesion and complete high tetraplegia.
- Initial symptoms included dysesthesia and hyperesthesia at and above the lesion site.
Observation:
- Five years post-injury, the patient reported increased pain intensity.
- Radiological investigation (CT scan) revealed an intraspinal bullet with a syringiform cyst projecting into the spinal cord.
Findings:
- While direct progression could not be objectively assessed due to lack of prior scans, chronic inflammation due to metal breakdown products from the bullet is suspected.
- The intraspinal bullet and associated cyst may be contributing to the patient's escalating pain.
Implications:
- This case highlights the potential for retained intraspinal foreign bodies, like bullets, to cause delayed complications.
- The type of metal composing the foreign body should be considered when determining surgical intervention for pain management and neurological preservation.