Ajmal Saad, Enam Syed Ather, Shamim Muhammad Shahzad
Section of Neurosurgery, Aga Khan University Hospital, P.O. Box 3500, Stadium Rd, Karachi 74800, Pakistan.
Spine J. 2009 Oct;9(10):e5-8. doi: 10.1016/j.spinee.2009.06.009. Epub 2009 Jul 29.
Firearm injuries to the spine may cause injury to the neurological structures and/or to the spine, including ligaments and bones.
Patients usually present with symptoms immediately after injury. However, only a few cases have been reported where a patient is neurologically intact after the initial injury but develops deficits several months or years later. Almost all these cases develop delayed neurological deficit because of bullet migration.
Case report.
A discussion, with a relevant review of the literature, the clinical histories, and radiological findings of two patients who experienced delayed neurological symptoms after gunshot wounds to the spine.
One patient presented after 14 years and the other after 5 months from the day of injury. Both cases are unique in that the delayed symptoms appeared because of formation of a reactive mass around the site of bullet impact. Lack of serial imaging studies is a barrier to the exclusion of bullet migration as an alternate cause of delayed symptoms.
These cases illustrate that retained intraspinal bullets can present with delayed neurological findings secondary to reactive changes around the bullet.
脊柱火器伤可能会导致神经结构和/或脊柱损伤，包括韧带和骨骼。
患者通常在受伤后立即出现症状。然而，仅有少数病例报道，患者在初次受伤时神经功能完好，但在数月或数年后出现神经功能缺损。几乎所有这些病例都是由于子弹移位导致延迟性神经功能缺损。
病例报告。
对两名脊柱枪伤后出现延迟性神经症状患者的临床病史和影像学检查结果进行讨论，并对相关文献进行回顾。
一名患者在受伤14年后就诊，另一名在受伤5个月后就诊。这两个病例的独特之处在于，延迟症状是由于子弹撞击部位周围形成反应性肿块所致。缺乏系列影像学研究是排除子弹移位作为延迟症状另一原因的障碍。
这些病例表明，椎管内残留子弹可因子弹周围的反应性改变而出现延迟性神经功能表现。
