2009
DOI: 10.1590/s1516-31802009000100011
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Abstract: CONTEXT: Lead poisoning due to retained gunshot bullets is a well-known clinical problem that is fairly frequently described in the literature. The risk factors for this occurrence relate mainly to whether the lead bullet is in contact with the joint fluid or cerebrospinal fluid (CSF). The treatment for these cases entails chelation therapy while symptoms are shown and definitive surgical removal of the bullet as a potential source of lead. The aim of this paper is to describe a clinical case of lead poisoning… Show more

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Cited by 17 publications
(16 citation statements)
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References 4 publications
(6 reference statements)
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“…10,11 If migration has been recognized, bullet removal is justified given the increased risk of obstructive hydrocephalus and additional injury to the CNS, especially for intraventricularly retained bullets. 15 It is worth noting that before proceeding with surgical removal, plain skull roentgenograms are indicated after final positioning of the head to ensure the location of the fragment.…”
Section: Discussionmentioning
confidence: 99%
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“…10,11 If migration has been recognized, bullet removal is justified given the increased risk of obstructive hydrocephalus and additional injury to the CNS, especially for intraventricularly retained bullets. 15 It is worth noting that before proceeding with surgical removal, plain skull roentgenograms are indicated after final positioning of the head to ensure the location of the fragment.…”
Section: Discussionmentioning
confidence: 99%
“…13 Lead poisoning is a well-recognized complication of retained bullets, with fairly frequent description even though only about 80 cases have been reported. 10,11 Despite several descriptions, the clinical significance of artificially implanted inorganic lead as a source of lead poisoning was not addressed until the recent study by McQuirter et al 11 These authors demonstrated in blood assays and lead measurements of trabecular and cortical bone that blood lead increases over time after an injury in cases of a retained bullet. This increase is mostly related to bone fracture caused by the gunshot.…”
Section: Discussionmentioning
confidence: 99%
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“…Furthermore, Richards [6] emphasized that there was no consensus among different spine centers about whether bullets in patients with spinal cord injuries should be removed, despite some evidence that those at or below T12 have higher re-ambulation rates after bullet removal [27]. Bullets in contact with cerebrospinal fluid may undergo electrolysis and cause plumbism, which is again a reason for bullet removal [28].…”
Section: Discussionmentioning
confidence: 99%
“…There are several human cases of lead poisoning owing to gunshot bullets (Coon et al, 2006;de Madureira et al, 2009). Lead poisoning mostly results when the lead bullet is put into contact with cerebrospinal fluid or joint fluid.…”
mentioning
confidence: 99%