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首页> 外文期刊>Neurocirugia >Cranio-thoracic bullet migration over a period of 27 years: case report
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Cranio-thoracic bullet migration over a period of 27 years: case report

机译：27年的颅胸子弹迁移：病例报告

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We report the case of a 36 year old woman that was hurt in the head with a lost bullet while walking through the street when she was 9 years old. On admission, the patient was fully conscious with no neurological deficits. Skull radiography showed the intracranial bullet but she was dispatched after 24 hours of observation without neurological deterioration. Six months later she suddenly presented quadriplegia and after one year of rehabilitation she recovered the mobility and strength in all her limbs. 25 years latter she began with thoracic pain (dermatomal sensory changes), constipation, paresthesias and weakness in the lower extremities; the X-Ray showed a bullet caliber 9 mm in the thoracic canal at T4 level. The bullet was removed via posterior laminectomy and dorsal midline mielotomy. 12 hours after surgery, the patient presented signs of medullar shock. The post-operatory MRI showed the trajectory of the bullet through the brain to the spinal cord in FLAIR, and spinal cord edema as well. The patient received steroids as treatment for the spinal cord edema, and with the help of rehabilitation she recovered movement in the lower extremities 30 days after the surgery.
机译：我们报告了一例36岁的女性，她9岁时在街上行走时头部丢失子弹，头部受伤。入院时，患者完全清醒，无神经功能缺损。颅骨X光片显示颅内子弹，但观察24小时后即被分派，无神经功能恶化。六个月后，她突然出现四肢瘫痪，经过一年的康复，她恢复了四肢的活动能力和力量。 25年后，她开始出现胸痛（皮肤感觉改变），便秘，感觉异常和下肢无力。 X射线显示T4级在胸管中9毫米口径。通过后路椎板切除术和背中线切开术去除子弹。手术后12小时，患者出现了髓样休克的体征。术后MRI显示子弹穿过大脑到达FLAIR中的脊髓的轨迹，以及脊髓水肿。患者接受类固醇激素治疗脊髓水肿，并在康复的帮助下，术后30天恢复了下肢的运动。

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