Korean J Neurotrauma.  2018 Apr;14(1):32-34. 10.13004/kjnt.2018.14.1.32.

Paraplegia Following Spinal Cord Contusion from an Indirect Gunshot Injury

• Khan K
• Dieudonne
• Saeed S
• Alothman S
• Saeed Y
• Gray S

• KMID: 2410919
• DOI: http://doi.org/10.13004/kjnt.2018.14.1.32

Abstract

Spinal cord injuries are debilitating and life threatening. Paraplegia due to direct traumatic gunshot injury to the spinal cord is common. The most common cause of spinal cord injury is road traffic accidents. This is followed by spinal cord injury due to a fall from a height. Most of the spinal cord injuries due to gunshot wounds occur as a result of direct traumatic effects. We present a rare case of a 49-year-old male with trauma. He developed paraplegia after a gunshot wound injury to the neck and contusion to the spinal cord, with no direct trauma. Paraplegia due to direct gunshot injury can have many different outcomes. In our case, the patient was managed conservatively, and the outcome was favorable.

Keyword

Paraplegia; Spinal cord; Wounds, gunshot

MeSH Terms

Accidents, Traffic
Contusions
Humans
Male
Middle Aged
Neck
Paraplegia*
Spinal Cord Injuries*
Spinal Cord*
Wounds, Gunshot

Figure

• 

  FIGURE 1 Gross image: tracheal injury with bullet traversing and exiting just above the right suprascapular region.

• 

  FIGURE 2 Sagittal magnetic resonance imaging showing spinal cord contusion with T1 transverse fracture as evident by focal area of intramedullary signal abnormality.

Reference

1. Chittiboina P, Banerjee AD, Zhang S, Caldito G, Nanda A, Willis BK. How bullet trajectory affects outcomes of civilian gunshot injury to the spine. J Clin Neurosci. 2011; 18:1630–1633. PMID: 22001241.

2. de Barros Filho TE, Cristante AF, Marcon RM, Ono A, Bilhar R. Gunshot injuries in the spine. Spinal Cord. 2014; 52:504–510. PMID: 24777161.

3. Devivo MJ. Epidemiology of traumatic spinal cord injury: trends and future implications. Spinal Cord. 2012; 50:365–372. PMID: 22270188.

4. Farmer JC, Vaccaro AR, Balderston RA, Albert TJ, Cotler J. The changing nature of admissions to a spinal cord injury center: violence on the rise. J Spinal Disord. 1998; 11:400–403. PMID: 9811100.

5. Goonewardene SS, Mangat KS, Sargeant ID, Porter K, Greaves I. Tetraplegia following cervical spine cord contusion from indirect gunshot injury effects. J R Army Med Corps. 2007; 153:52–53. PMID: 17575878.

6. Klack F, Tassin C, Cotton F, Luaute J, Gauthier J, David JS. Gunshot injury without direct injury to the cord may lead to complete paraplegia. Eur J Trauma Emerg Surg. 2011; 37:49–51. PMID: 26814750.

7. le Roux JC, Dunn RN. Gunshot injuries of the spine-a review of 49 cases managed at the Groote Schuur Acute Spinal Cord Injury Unit. S Afr J Surg. 2005; 43:165–168. PMID: 16440591.

8. Mirovsky Y, Shalmon E, Blankstein A, Halperin N. Complete paraplegia following gunshot injury without direct trauma to the cord. Spine (Phila Pa 1976). 2005; 30:2436–2438. PMID: 16261122.

9. Secer M, Ulutaş M, Yayla E, Cinar K. Upper cervical spinal cord gunshot injury without bone destruction. Int J Surg Case Rep. 2014; 5:149–151. PMID: 24566426.

10. Sidhu GS, Ghag A, Prokuski V, Vaccaro AR, Radcliff KE. Civilian gunshot injuries of the spinal cord: a systematic review of the current literature. Clin Orthop Relat Res. 2013; 471:3945–3955. PMID: 23479233.