We have located links that may give you full text access.
CASE REPORTS
JOURNAL ARTICLE
[Endoscopic projectile extraction in treatment of a gunshot injury to the head].
Deutsche Medizinische Wochenschrift 1998 September 26
HISTORY AND CLINICAL FINDINGS: A 14-year-old boy had in war-torn Bosnia sustained a transcranial gunshot wound from a 7.65 mm bullet. After primary medical care with craniotomy and the removal of bony fragments and cerebral debris followed by a duraplasty, he was transported to the French-German Field Hospital. On arrival he was breathing spontaneously and in stable cardiovascular state but with impaired responsiveness and somnolent. His pupils were moderately dilated with slight anisocoria (right > left). His gaze was deviated to the left and he had vertical gaze paralysis as well as right central facial nerve paresis. In addition he had a mild diencephalic syndrome, right hemiplegia and a right hemihypaesthesia with increased muscle tone, especially of the leg, paratonia and right positive Babinski reflex. There also was a marked ciliospinal reflex and he had a bulbar speech as well as cognitive and memory abnormalities.
INVESTIGATIONS: Haemoglobin and haematocrit were below normal (12.1 g/dl and 35.0%, respectively), while biochemical tests were normal. Cranial computed tomography localized the bullet in the pineal recess of the 3rd ventricle and the lamina quadrigemina.
DIAGNOSIS, TREATMENT AND COURSE: These findings indicated endoscopic transcranial removal of the bullet, achieved with a rigid endoscope and forceps along the entry track. Subsequent intensive care proceeded without complication. On discharge the boy was normal oriented and ready to make contact. The neurological defects were regressing.
CONCLUSION: Endoscopic transcranial removal of a bullet wedged in the brain is a relatively sparing neurological procedure which, under unusual circumstances and conditions, can achieve a satisfactory result even with limited facilities.
INVESTIGATIONS: Haemoglobin and haematocrit were below normal (12.1 g/dl and 35.0%, respectively), while biochemical tests were normal. Cranial computed tomography localized the bullet in the pineal recess of the 3rd ventricle and the lamina quadrigemina.
DIAGNOSIS, TREATMENT AND COURSE: These findings indicated endoscopic transcranial removal of the bullet, achieved with a rigid endoscope and forceps along the entry track. Subsequent intensive care proceeded without complication. On discharge the boy was normal oriented and ready to make contact. The neurological defects were regressing.
CONCLUSION: Endoscopic transcranial removal of a bullet wedged in the brain is a relatively sparing neurological procedure which, under unusual circumstances and conditions, can achieve a satisfactory result even with limited facilities.
Full text links
Related Resources
Trending Papers
Proximal versus distal diuretics in congestive heart failure.Nephrology, Dialysis, Transplantation 2024 Februrary 30
World Health Organization and International Consensus Classification of eosinophilic disorders: 2024 update on diagnosis, risk stratification, and management.American Journal of Hematology 2024 March 30
Heart failure with preserved ejection fraction: diagnosis, risk assessment, and treatment.Clinical Research in Cardiology : Official Journal of the German Cardiac Society 2024 April 12
Get seemless 1-tap access through your institution/university
For the best experience, use the Read mobile app
All material on this website is protected by copyright, Copyright © 1994-2024 by WebMD LLC.
This website also contains material copyrighted by 3rd parties.
By using this service, you agree to our terms of use and privacy policy.
Your Privacy Choices
You can now claim free CME credits for this literature searchClaim now
Get seemless 1-tap access through your institution/university
For the best experience, use the Read mobile app