de Oliveira Barbosa MD, de Bellis T, Pousa MS, da Silva RSC, Garcia FA, Acioly MA. Treatment strategy in a child with a retained bullet in the cerebellomedullary cistern.
J Neurosurg Pediatr 2012;
10:192-4. [PMID:
22793164 DOI:
10.3171/2012.5.peds1239]
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Abstract
A 6-year-old girl was admitted to our emergency room because of a gunshot wound in the posterior craniocervical junction. On admission, she was alert, but left hemiplegia and right hemiparesis were noted. Cranial CT scanning showed a retained bullet in the cerebellomedullary cistern without bone destruction. Moreover, fourth ventricle hemorrhage was observed. There were no signs of acute hydrocephalus. The patient underwent suboccipital craniectomy and C-1 laminectomy for bullet removal. Postoperatively, the patient experienced significant neurological improvement. To the best of the authors' knowledge, this is the first documented case of a patient with a retained bullet in the cerebellomedullary cistern. The management strategies in such a unique case are discussed.
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