Kerbler S, Schober P H, Steiner H
Univ.-Kinderklinik Graz.
Z Kinderchir. 1990 Oct;45(5):301-3. doi: 10.1055/s-2008-1042605.
A 3 mm metallic particle, which had blasted during grinding operation, shot into the neck of a nine year old boy, penetrated into the common carotid artery and embolized the right middle cerebral artery. There had been no neurological symptoms until four days after the injury. Suddenly, a mild left side hemiparesis occurred with accentuation of the arm. The case illustrates an unusual penetration and intravascular migration of a foreign body. After the injury, penetration and subsequent peripheric embolisation can happen immediately, or as in our case within a short time after. Hence, the small particle may not be detected by a local radiogram, or may not be found on surgical exploration. Therefore, in all cases of neck wounds caused by low velocity injection of foreign bodies, radiological evaluation with skull-x-rays and a neurological examination should be done. If further special scans are required, these should be accomplished by axial computer tomography, because the metallic nature of the foreign bodies would prohibit the examination by magnetic resonance.
一个在磨削操作过程中爆裂的3毫米金属颗粒射入一名9岁男孩的颈部，穿透颈总动脉并栓塞右大脑中动脉。受伤后四天内一直没有神经症状。突然，出现轻度左侧偏瘫，以手臂为重。该病例说明了异物的异常穿透和血管内迁移。受伤后，穿透及随后的外周栓塞可能立即发生，或者如我们的病例在短时间后发生。因此，小颗粒可能无法通过局部X线片检测到，或者在手术探查中找不到。因此，在所有由低速异物注射引起的颈部伤口病例中，应进行头颅X线放射学评估和神经学检查。如果需要进一步的特殊扫描，应通过轴向计算机断层扫描完成，因为异物的金属性质会妨碍磁共振检查。
