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CC BY-NC-ND 4.0 · Arquivos Brasileiros de Neurocirurgia: Brazilian Neurosurgery 2021; 40(04): e404-e407
DOI: 10.1055/s-0041-1731063
Case Report | Relato de Caso

Multiple Brain Abscesses by an Air Gun Shot: A Case Report

Abscessos cerebrais múltiplos por tiro de arma de ar comprimido: relato de caso
Mohammad Jamali
1   Department of Neurosurgery, Shiraz University of Medical Sciences, Shiraz, Iran
,
Iman Ahrari
1   Department of Neurosurgery, Shiraz University of Medical Sciences, Shiraz, Iran
,
Keyvan Eghbal
1   Department of Neurosurgery, Shiraz University of Medical Sciences, Shiraz, Iran
,
Arash Saffarrian
1   Department of Neurosurgery, Shiraz University of Medical Sciences, Shiraz, Iran
,
Abbas Rakhsha
1   Department of Neurosurgery, Shiraz University of Medical Sciences, Shiraz, Iran
,
Sulmaz Ghahramani
2   Health Policy Research Center, Institute of Health, Shiraz University of Medical Sciences, Shiraz, Iran
› Author Affiliations Funding This research did not receive any specific grant from funding agencies in the public, private, or not-for-profit sectors.
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Abstract

Introduction Low-velocity penetrating brain injury is not prevalent. In some conditions such as childhood, and with the penetration of a pellet in weak spots of skull, low-velocity penetrating brain injury is expected; however, high-velocity projectiles have also been reported as the cause of severe brain injuries. One of the complications of penetrating brain injury is infection, in which different types of microorganisms play a role. The Streptococcus genus is the leading cause of abscess formation in non-traumatic patients. Multiple brain abscesses are not common.

Case Presentation A 10-year-old boy with penetrating brain injury caused by an air gun pellet, who developed signs and symptoms of high intracranial pressure 18 days after the trauma. After the imaging scans and the detection of multiple brain abscesses and severe brain edema, prompt surgical intervention was performed for all three lesions in a single operation. The culture of a pus specimen was positive for Streptococcus species, and, with adequate antibiotic therapy, the patient was discharged from the hospital in good condition.

Conclusion Brain injury with air gun shot is not prevalent. The penetration of a low-velocity air gun pellet in weak points of the skull (such as the orbit, the squamous portion of the temporal bone, and the cranial suture), specially in children, can cause significant brain injuries.

Resumo

Introdução A lesão cerebral penetrante de baixa velocidade não é prevalente. Em algumas condições, como na infância e com a penetração de bala em pontos fracos do crânio, é esperada lesão cerebral penetrante de baixa velocidade; no entanto, projéteis de alta velocidade também foram relatados como a causa de lesões cerebrais graves. Uma das complicações da lesão cerebral penetrante é a infecção, na qual diferentes tipos de microrganismos desempenham um papel. O gênero Streptococcus é a principal causa de formação de abscesso em pacientes não traumáticos. Abcessos cerebrais múltiplos não são comuns.

Relato do caso Um menino de dez anos com traumatismo cranioencefálico penetrante causado por projétil de arma de ar comprimido que desenvolveu sinais e sintomas de pressão intracraniana elevada 18 dias após o trauma. Após os exames de imagem e a detecção de múltiplos abscessos cerebrais e edema cerebral grave, a intervenção cirúrgica imediata foi realizada para todas as três lesões em uma única operação. A cultura de uma amostra de pus foi positiva para espécies de Streptococcus e, com antibioticoterapia adequada, o paciente recebeu alta hospitalar em boas condições.

Conclusão Lesões cerebrais por arma de ar comprimido não são comuns. A penetração de uma bala de arma de ar comprimido de baixa velocidade em pontos fracos do crânio (como a órbita, a porção escamosa do osso temporal e a sutura craniana), especialmente em crianças, pode causar lesões cerebrais significativas.

Keywords

air gun shot - brain abscess - Shiraz

Palavras-chave

tiro de arma de ar comprimido - abscesso cerebral - Shiraz

Statement of Ethics

The patient's parents have given their written informed consent to publish the case (including the publication of images).




Publication History

Received: 31 July 2020

Accepted: 09 March 2021

Article published online:
03 August 2021

© 2021. Sociedade Brasileira de Neurocirurgia. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commecial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

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