Citation

Harsha KJ, Thomas A. Asian J. Neurosurg. 2018; 13(2): 433-435.

Affiliation

Department of Neurosurgery, Brain and Spine Centre, Indo-American Hospital, Chemmanakary, Vaikom, Kerala, India.

Copyright

(Copyright © 2018, Medknow Publications)

DOI

10.4103/1793-5482.228565

PMID

29682053

PMCID

PMC5898124

Abstract

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.

Language: en

Keywords

Cauda equina injury; magnetic resonance imaging; missile injury; spine surgery