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Shotgun pellet embolism to the brain

M A Dada1, I A Loftus, G S Rutherfoord

  • 1Department of Forensic Medicine, University of Stellenbosch, Cape Town, South Africa.

Insights

A shotgun pellet caused a brain infarct in a young man after lodging in the right middle cerebral artery. This autopsy case highlights the need for detailed examination of cerebral vasculature in infarction cases.

Area of Science:

  • Neurology
  • Forensic Pathology
  • Cardiovascular Science

Background:

  • Shotgun injuries can lead to complex neurological complications.
  • Cerebral infarction is a critical outcome requiring thorough investigation of its etiology.
  • Autopsy plays a crucial role in identifying the cause of death in trauma cases.

Observation:

  • A young man presented with a fatal shotgun injury.
  • Clinical suspicion did not initially identify a cerebral infarct.
  • Autopsy revealed an unexpected infarct in the right middle cerebral artery territory.

Findings:

  • A shotgun pellet was identified as the cause of the infarct.
  • The embolus was located proximal to the trifurcation of the right middle cerebral artery.
  • This finding established a direct link between the projectile and the ischemic event.

Implications:

  • Thorough postmortem examinations are vital, especially in cases of unexplained neurological deficits.
  • Detailed examination of cerebral vasculature is essential for diagnosing embolic events.
  • This case emphasizes the potential for projectile emboli to cause significant vascular occlusion and infarction.

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