Romanian Neurosurgery (Mar 2020)
The role of strict patient-positioning during nursing in the management of intracerebral migration of gravitational bullet injury
Abstract
The intracranial migration of bullet was described in literature since Cushing time and the First World War [1]. The literature is still away from delivering a clear guideline and constitutes more of case reports rather than comprehensive well-designed studies [2-13], this mostly due to the variability and diversity in the presentation and management of such cases. The migration of bullet can be a sequel of any type of penetrating injury to the skull [14]. Intracranial migration after gravitational (falling) bullet injury is a unique type of injury that constitutes of significant human and material losses with differences in biomechanics and structural brain changes after the insult especially regarding the velocity of impact and the degree of yaw for the intracranially settled bullet [15]. The gravitational bullets injuries are considered by the international disease classification system as celebratory firing, that is quite common and is part of the traditional happy (marriage) or funeral event in the middle east in general and in rural areas of Iraq in particular, and also reported in some areas around the world (South America, North Africa, and middle of Asia) [15,16].
