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Summary
A bullet from a gunshot wound to the head traveled to the pulmonary artery in the chest. The patient remains asymptomatic aside from focal epilepsy.
Area of Science:
- Neurology
- Cardiology
- Trauma Surgery
Background:
- Gunshot wounds to the head present complex challenges in ballistics and patient management.
- Intracranial bullet migration is a rare but documented phenomenon.
Observation:
- A .22-caliber bullet entered the head and lodged in the superior sagittal sinus.
- The bullet subsequently migrated from the cranial vault to the thoracic cavity.
Findings:
- The migrated bullet permanently embolized within a branch of the left pulmonary artery.
- The patient is clinically stable and asymptomatic, with the exception of focal epilepsy.
Implications:
- This case highlights the potential for delayed intracranial bullet migration and embolization.
- Understanding bullet trajectory is crucial for managing penetrating head trauma.
- Long-term neurological sequelae, such as epilepsy, can occur even with asymptomatic embolization.