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Penetrating shrapnel injuries of the posterior fossa

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Abstract

Background

Gunshot injuries of the posterior fossa are rare and may follow a fatal course. In posterior fossa gunshot injuries, cerebellar hematoma, contusion, obstruction of cerebrospinal fluid (CSF) circulation by the shrapnel, and intracranial hypertension caused by autoregulation loss lead to mortality in the early stage.

Methods

In this study, four cases of patients who underwent surgical intervention after penetrating shrapnel injuries of the pure posterior fossa were evaluated.

Results

All of the patients were male; their mean age was 26.5 ± 5 years. The lowest and highest Glasgow Coma Scale scores were 4 and 12, respectively. Neural injury was detected by computed tomography performed after systemic and neurological examination following admission to the emergency service. The shrapnel was found in the cerebellar tissue in three cases and in the fourth ventricle in one case. Following preoperative procedures, surgery was performed with the patient in the prone position. Postoperative monitoring revealed no CSF fistula, meningitis, or hydrocephalus. None of the patients required revision surgery. There were no postoperative mortalities.

Conclusion

Due to the small volume of the posterior fossa, acute pathologies may lead to rapid neurological deterioration and death. Early surgical intervention and close postoperative follow-up after penetrating shrapnel injuries of the posterior fossa play a significant role in reducing mortality and morbidity.

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Conflict of interest

M. Seçer, M. Ulutaş, F. Alagöz, K. Çınar and E. Yayla declare that they have no conflict of interest.

Ethical standards

This article does not contain any studies with human participants or animals performed by any of the authors.

Informed consent

Written informed consent was obtained from the patient’s relative who participated in this study.

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Authors and Affiliations

  1. Department of Neurosurgery, Deva Hospital, Osmangazi mah. 14 nolu Cadde 162/1 Şehitkamil, Gaziantep, 27560, Turkey

    M. Seçer

  2. Department of Neurosurgery, Sanko Hospital, Gaziantep, Turkey

    M. Ulutaş

  3. Department of Neurosurgery, Ankara Numune Educational and Training Hospital, Ankara, Turkey

    F. Alagöz

  4. Department of Neurosurgery, Şehitkamil State Hospital, Gaziantep, Turkey

    K. Çınar & E. Yayla

Authors
  1. M. Seçer
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  2. M. Ulutaş
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  3. F. Alagöz
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  4. K. Çınar
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  5. E. Yayla
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Corresponding author

Correspondence to M. Seçer.

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Seçer, M., Ulutaş, M., Alagöz, F. et al. Penetrating shrapnel injuries of the posterior fossa. Eur J Trauma Emerg Surg 41, 157–160 (2015). https://doi.org/10.1007/s00068-014-0481-9

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  • DOI: https://doi.org/10.1007/s00068-014-0481-9

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