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Gunshot injury to the face with a missile lodged in the upper cervical spine without neurological deficit

M Bumbasirevic1, A Lesic1, V Bumbasirevic2, Z Rakocevic3 and M Djuric*,4

1 Institute for Orthopaedic Surgery and Traumatology, University Clinical Centre, Visegradska 26, 11000 Belgrade, Serbia; 2 Institute for Anesthesiology and Intensive Care, University Clinical Centre, Belgrade, Visegradska 26, 11000 Belgrade, Serbia; 3 Department of Radiology, Dental School, University of Belgrade, Rankeova 6, 11000 Belgrade, Serbia; 4 Department of Anatomy, Medical Faculty, University of Belgrade, Dr Subotica 4/2, 11000 Belgrade, Serbia


Figure 1
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  		Figure 1 Photograph of the patient after surgical management of the wound

 

Figure 2
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  		Figure 2 (a) Radiograph of the skull in posteroanterior projection showing the missile at the level of the nasal cavity; (b) radiograph of the cervical spine in lateral projection showing the missile at the level of the anterior portion of atlas, behind the odontoid process of the axis

 

Figure 3
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  		Figure 3 Photograph of the patient 13 years after injury

 

Figure 4
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  		Figure 4 CT section indicating position of the missile on the medial aspect of the right lateral mass of the atlas

 

Figure 5
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  		Figure 5 3D reconstruction of the facial skeleton showing healed fracture of the right nasal bone

 

Figure 6
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  		Figure 6 CT section at the level of nasal cavity showing disturbed architecture of the ethmoidal labyrinth on the right side

 

Figure 7
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  		Figure 7 Reconstruction of the missile trajectory in midsagittal plane and termination of the missile

 

Figure 8
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  		Figure 8 3D reconstruction of the cranial base and cervical spine showing defect of the arch of atlas

 




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