Gipe B T, Acker B, Smith R
J Trauma. 1981 Apr;21(4):326-9. doi: 10.1097/00005373-198104000-00012.
A case of shotgun pellet embolization to the middle cerebral artery is presented. Embolization occurred approximately 36 hours following successful resuscitation of blood pressure, respirations, and neurologic function in a 21-year-old man who had sustained a massive chest wound. The diagnosis of pellet embolization was made within 8 hours of the onset of neurologic deficits; however, fatal cerebral infarction had occurred before surgery could be undertaken. Seven similar cases are briefly reviewed and it is concluded that low velocity and low kinetic energy missiles are more likely to embolize, and that left lower extremity injuries are more frequently involved in embolization. In all cases of shotgun trauma to the chest cerebral embolization of pellets should be considered at any sign of neurologic change and skull films obtained. Surgical intervention is necessary before cerebral infarction.
本文报告一例大脑中动脉霰弹枪子弹栓塞病例。一名21岁男性胸部受重伤，在成功复苏血压、呼吸和神经功能约36小时后发生栓塞。在神经功能缺损出现8小时内确诊为子弹栓塞；然而，在能够进行手术之前已发生致命性脑梗死。简要回顾了7例类似病例，得出结论：低速和低动能导弹更易发生栓塞，且栓塞更常累及左下肢损伤。在所有胸部霰弹枪创伤病例中，一旦出现任何神经功能改变迹象，均应考虑子弹脑栓塞可能，并进行颅骨拍片。在发生脑梗死之前必须进行手术干预。
