Koçak Ayhan, OZer Mehmet Haluk
Diyarbakir Military Hospital, Department of Neurosurgery, Diyarbakir, Turkey.
Am J Forensic Med Pathol. 2004 Sep;25(3):246-50. doi: 10.1097/01.paf.0000127403.97576.0b.
Retained bullets and fragments following a civilian gunshot injury are quite frequent in practical neurosurgery. It is usually possible to extract the foreign body surgically, while rare cases are conservatively treated because of technical reasons. Conservative treatment may present complications, and a rare form of this presentation is migration of the bullet. A 20-year-old man presented with migrating bullet from a supratentorial to opposite infratentorial area. We consider that in the migrating bullet fragment cases, if there is no contraindication, the most reasonable treatment is its urgent surgical removal. This report reveals a supratentorial bullet migrating to the infratentorial contralateral area, and related literature considering the different mechanisms of migration is discussed.
在实际神经外科手术中,平民枪伤后残留子弹和碎片的情况相当常见。通常可以通过手术取出异物,而少数情况因技术原因采用保守治疗。保守治疗可能会出现并发症,其中一种罕见的表现形式是子弹移位。一名20岁男性出现子弹从幕上区域移位至对侧幕下区域的情况。我们认为,在子弹碎片移位的病例中,如果没有禁忌证,最合理的治疗方法是紧急手术取出。本报告揭示了一枚幕上子弹移位至对侧幕下区域的情况,并讨论了考虑不同移位机制的相关文献。