Home-made gun injury: spontaneous version and anterior migration of bullet

Abstract

We report a unique case of a self-inflicted brain injury using an ingenious home-made gun with spontaneous anterior migration of the intact bullet. On admission, the patient was fully conscious with no neurological deficits. Computed tomography (CT) confirmed a penetrating missile injury with transventricular across midline trajectory and multi-lobe injury with the bullet lodged in the occipital lobe. Serial CT revealed spontaneous version with anterior migration of the bullet from the occipital lobe to finally come to rest in the ipsilateral frontobasal region. The bullet was removed via a left supra-orbital craniotomy. The patient experienced good outcome. Home-made gun injuries, although uncommon today, represent a special form of missile injury with unique low velocity terminal ballistics. As these weapons are seen infrequently today, surgeons should be alerted to their existence as patients with this form of injury usually have a good prognosis if vital brain structures are spared.

Craniocerebral injury by penetration of a T-shaped metallic spanner: A rare presentation

“…[8] Similarly, many other successfully managed cases of PBI have been reported from Africa. [2283538] Our case further corroborates the notion that the multiple limitations of neurosurgical practice in an African nation do not prevent the successful management of select cases of penetrating head trauma. [8]…”

Spontaneous relocation of intracranial bullet

“…Interestingly enough, the orientation of the bullet remained unchanged. G.Alessi et al have described spontaneous version and anterior migration of the bullet again with the orientation of the bullet remaining unchanged 8 . Ross D et al have reported two cases of spontaneous migration of retained bullets 9 .…”

An Unusual Zip Gun Suicide—Medicolegal and Ballistic Examination

“…The literature (1)(2)(3)(4)(5)(6)(7)(8) shows that persons using home-made guns to commit suicide were exclusively men. Women who commit suicide with a firearm typically use guns of serial production.…”

“…Worldwide, cases in which a home‐made firearm is used to perform an intended suicide are very rare. The literature describes only tens of such cases by means of these unusual firearms (1–8). Unfortunate accidents (9,10) and homicides (11,12) are extremely uncommon.…”