Open AccessPenetrating injury to cauda equina from a missile fragment, completely recovered after delayed surgical removal of ballistic fragment
Author(s) -
Kamble Jayaprakash Harsha,
Anu Thomas
Publication year - 2018
Publication title -
asian journal of neurosurgery
Language(s) - English
Resource type - Journals
ISSN - 2248-9614
DOI - 10.4103/1793-5482.228565
Subject(s) - medicine , cauda equina , gunshot injury , surgery , magnetic resonance imaging , penetrating trauma , radiology , spinal cord , psychiatry , blunt
Penetrating injuries to cauda equina due to missile fragment are rare. The mechanism of injury may be more complex due to thermal effect of missile fragment, apart from mechanisms described in penetrating gunshot injuries or stab injuries. We report a case of a 42-year-old male with penetrating missile injury to cauda equina, improved completely after delayed surgical exploration and removal of ballistic fragment. Furthermore, his bowel and bladder dysfunction improved completely within 1 week of neurosurgical exploration. Although early neurosurgical intervention is recommended for penetrating injuries of the cauda equina, delayed intervention may also be beneficial in selected patients. Computed tomography (CT) scan and CT myelogram are extremely useful in surgical planning when magnetic resonance imaging contraindicated due to impregnated metal fragments.