Trauma Case Reports (Dec 2018)

Successful surgical treatment of a patient with combined gunshot shrapnel injuries in the heart and brain complicated by middle cerebral artery pseudoaneurysm

  • Andrii Sirko,
  • Ihor Kyrpa,
  • Vasyl Lazorishinets,
  • Mykola Zorin,
  • Yuri Cherednychenko,
  • Illya Plyushchev,
  • Dmytro Romanukha

DOI
https://doi.org/10.1016/j.tcr.2018.11.001
Journal volume & issue
Vol. 18
pp. 17 – 23

Abstract

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Summary: Successful step-by-step treatment of a combined gunshot shrapnel injury of the brain, damaging the left middle cerebral artery (MCA) branches, and penetrating myocardium injury is discussed. Open brain and heart surgeries were performed. A left MCA pseudoaneurysm was formed postoperatively. Endovascular exclusion of the left MCA pseudoaneurysm was performed using detachable micro coils. Finally, plastic reconstruction of the posttraumatic cranial vault defect was performed using a dynamic titanium plate.Treatment of severe combined gunshot shrapnel brain injury with formation of MCA pseudoaneurysm and a penetrating myocardium injury requires a multimodal approach involving related specialists (neurosurgeon, cardiosurgeon and interventional radiologist). Keywords: Gunshot wound, Craniocerebral shrapnel injury, Shrapnel injury of the heart, False aneurysm, Dissectional aneurysm, Middle cerebral artery