case_images: PMC4414003_01
case_images: Lateral scout CT head and neck image at presentation.
case_images: 13032_2014_92_Fig1_HTML.jpg
case_images: PMC4414003_01_13032_2014_92_Fig1_HTML.jpg
case_images: Fig1
case_images: The CT head lateral scout revealed a single intracranial pellet, projected over the pterion (Figure 1 arrow).
case_images: Axial image from non-contrast CT brain at presentation.
case_images: 13032_2014_92_Fig2_HTML.jpg
case_images: PMC4414003_01_13032_2014_92_Fig2_HTML.jpg
case_images: Fig2
case_images: Non-contrast CT demonstrated early signs of an acute MCA infarct with loss of the insula ribbon grey-white matter differentiation and subtle hypoattenuation within the putamen and globus pallidus (Figure 2 white oval).
case_images: CT angiography at 24 hours post presentation.
case_images: 13032_2014_92_Fig3_HTML.jpg
case_images: PMC4414003_01_13032_2014_92_Fig3_HTML.jpg
case_images: Fig3
case_images: Follow-up CT angiography performed 24 hours after arrival showed complete reperfusion of the right middle cerebral artery (Figure 3) with the shot fragment seemingly unchanged in position (arrow).
case_images: Axial images CT carotid and Circle of Willis angiogram.
case_images: 13032_2014_92_Fig4_HTML.jpg
case_images: PMC4414003_01_13032_2014_92_Fig4_HTML.jpg
case_images: Fig4
case_images: CT angiography of the neck revealed a focal dissection (Figure 4 arrow) and linear focus of thrombus within the right common carotid artery 5 cm inferior to the bifurcation, at the presumed arterial entry point of the embolised pellet.
case_images: PMC4414003_02
case_images: CT scout view pelvis and upper thigh.
case_images: 13032_2014_92_Fig5_HTML.jpg
case_images: PMC4414003_02_13032_2014_92_Fig5_HTML.jpg
case_images: Fig5
case_images: A 2 mm rounded metallic shot fragment was seen to lie within the proximal right iliolumbar vein, with the pellet projected over the sacrum on the AP supine radiograph and CT scout images (Figure 5 arrow).
case_images: Axial post contrast CT image.
case_images: 13032_2014_92_Fig6_HTML.jpg
case_images: PMC4414003_02_13032_2014_92_Fig6_HTML.jpg
case_images: Fig6
case_images: The pellet was seen to lie within the left iliolumbar vein (Figure 6 arrow), distant to the site of penetrating firearm trauma.