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Tetraplegia following cervical spine cord contusion from indirect gunshot injury effects
  1. SS Goonewardene1,
  2. KS Mangat1,
  3. ID Sargeant1,
  4. Keith Porter, MBBS FRCS(Ed) FRCS (Eng) FIMCRCS(Ed) MFSEM (Ed), Honorary Professor of Traumatology and Consultant Trauma Surgeon1 and
  5. I Greaves2
  1. 1South Birmingham Trauma Unit, Selly Oak Hospital, Raddlebarn Road B29
  2. 2James Cook University Hospital, Marton Rd, Middlesbrough TS4 3BW


We present the case of a 31 year old British soldier who sustained a high energy gunshot injury to the neck with delayed onset tetraplegia. The bullet’s transcervical track was subsequently shown to have had no direct contact with the spinal cord, but four to five minutes after injury the patient developed tetraplegia. Subsequent Magnetic Resonance Imaging confirmed this to be due to contusion of the cervical spinal cord. This case illustrates the high levels of energy potentially transferred to surrounding tissues by the passage of a high available energy projectile, causing significant injury to nearby structures not actually impacted by the missile.

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