Citation

Negrotto M, Figueroa R, Sotomayor K (2019) Multidirectional Spontaneous Migration of Intracranial Bullet: A Case Report and Literature Review. Neurosurg Cases Rev 2:019. doi.org/10.23937/2643-4474/1710019

Copyright

© 2019 Negrotto M, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and sreproduction in any medium, provided the original author and source are credited.

Case Report | OPEN ACCESS DOI: 10.23937/2643-4474/1710019

Multidirectional Spontaneous Migration of Intracranial Bullet: A Case Report and Literature Review

Matías Negrotto*, MD, Ramon Figueroa, MD and Katherine Sotomayor, MD

Department of Radiology, Medical College of Georgia, Augusta University, USA

Abstract

Although gunshot injury to the head is usually mortal, survivors frequently show retained metal shrapnel or full bullet intracranially. An important though uncommon complication of retained bullet is that of spontaneous migration. A migrating intracranial bullet is a dilemma to neurosurgeons, as its management is challenging, since the removal of a deep-seated bullet may cause additional neurological deficit. Migration of a retained bullet may cause damage to vital structures and cranial nerves, producing significant neurological damage. We report the case of a 23-year-old man who received a bullet in the head and during one month, several CT scans showed multidirectional spontaneously migrating bullet within the intracranial space. The patient was conscious with a right hemianopsia but no other eloquent neurologic deficit, even after his single seizure episode. Neurosurgery consultant opted for not removing the bullet.