The fate of retained intracerebral shotgun pellets

Sights, Warren P.; Bye, Robert J.

doi:10.3171/jns.1970.33.6.0646

Cited by 37 publications

(6 citation statements)

References 14 publications

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“…Copper induces significant inflammatory reactions compared to other studied metals . An older report associates gunshot wounds with copper pellets with sterile abscesses and seizures . The role of inflammation in epilepsy and seizures is under active investigation, so the reported inflammatory reaction to the copper could play a role in the development of epilepsy in these animals.…”

Section: Discussionmentioning

confidence: 99%

A model of posttraumatic epilepsy after penetrating brain injuries: Effect of lesion size and metal fragments

2014

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Objective Penetrating brain injury (PBI) has the highest risk for inducing post-traumatic epilepsy and retained foreign materials such as bullet fragments carry the greatest risk. This study examines the potential contribution of copper, a major component of bullets, to the development of epilepsy following PBI. Methods Anesthetized adult male rats received a penetrating injury from the dorsal cortex to the ventral hippocampus from a high speed small bit drill. In one group of animals, copper wire was inserted into the lesion. Control animals had only the lesion or the lesion plus stainless steel wire (biologically inert foreign body). From 6 to up to 11 months following the injury the rats were monitored intermittently for the development of epilepsy with video-EEG. A separate set of animals was examined for possible acute seizures in the week following the injury. Results 22 of the 23 animals with copper wire developed chronic epilepsy compared to 3 of the 20 control rats (lesion and lesion with stainless steel). Copper was associated with more extensive injury. The control rats with epilepsy had larger lesions. In the acute injury group, there was no difference in the incidence of seizures (83% lesion plus stainless steel, 70% lesion plus copper). Conclusions Copper increases the risk for epilepsy and may increase damage over time, but there were no differences between the groups in the incidence of acute post-injury seizures. Lesion size may contribute to epilepsy development in lesion only animals. Copper maybe an independent risk factor for the development of epilepsy and possible secondary injury, but lesion size also contributes to the development of epilepsy. The consequences of prolonged exposure of the brain to copper observed in these animals may have clinical implications that require further evaluation.

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Section: Discussionmentioning

confidence: 99%

A model of posttraumatic epilepsy after penetrating brain injuries: Effect of lesion size and metal fragments

2014

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“…Copper migration through nervous tissue is also well known. [10][11][12] No reports of migration have been published concerning copper fragments located in more dense tissues like the liver.…”

Section: Discussionmentioning

confidence: 99%

Presumed Migration Of An Intra-Abdominal Copper Fragment

Balthazar¹,

Samra²,

Wigle³

2015

AMSRJ

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“…16 Some cases have also been attributed to inflammatory reactions to metallic fragments in the central nervous system. Copper, for example, is associated with severe scarring and necro- sis, 33 silver with a marked inflammatory response, 28 nickel and lead with more intermediate responses, 40 and gold and platinum with minimal responses. Stainless steel incites a variable response, depending on its particular composition.…”

Section: Surgical Managementmentioning

confidence: 99%

Hypoglossal nerve palsy after posterior screw placement on the C-1 lateral mass

Hong

Lee²,

Son³

et al. 2006

SPI

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✓ Atlantoaxial fixation in which C1–2 screw–rod fixation is performed is a relatively new method. Because reports about this technique are rather scant, little is known about its associated complications. In this report the authors introduce hypoglossal nerve palsy as a complication of this novel posterior atlantoaxial stabilization method. A 67-year-old man underwent a C1–2 screw–rod fixation for persistent neck pain resulting from a Type 2 odontoid fracture that involved disruption of the transverse atlantal ligament. Posterior instrumentation in which a C-1 lateral mass screw and C-2 pedicle screw were placed was performed. Postoperatively, the patient suffered dysphagia with deviation of the tongue to the left side. At the 4-month follow-up examination, bone fusion was noted on plain x-ray studies of the cervical spine. His hypoglossal nerve palsy resolved completely 2 months postoperatively. To the authors’ knowledge, this is the first report in the literature of hypoglossal nerve palsy following C1–2 screw–rod fixation. The hypoglossal nerve is one of the structures that can be damaged during C-1 lateral mass screw placement.

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The fate of retained intracerebral shotgun pellets

Cited by 37 publications

References 14 publications

A model of posttraumatic epilepsy after penetrating brain injuries: Effect of lesion size and metal fragments

A model of posttraumatic epilepsy after penetrating brain injuries: Effect of lesion size and metal fragments

Presumed Migration Of An Intra-Abdominal Copper Fragment

Hypoglossal nerve palsy after posterior screw placement on the C-1 lateral mass

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