A case study of paraplegia from an indirect gunshot injury

Spinal cord injury (SCI) is a serious global health concern. Most incidents of SCI result from traffic accidents or falls from height, but this kind of injury may also be caused by direct trauma from gunshot wounds. In some rare cases, indirect trauma – that is, trauma to areas other than the spinal cord – can cause SCI, resulting in death, paraplegia, and other irreversible outcomes.

A team of clinicians in New York reported on a rare case study of a 49-year-old man who experienced paraplegia after a gunshot wound. Although the bullet entered the man’s neck, it did not make direct contact with his spine. However, he soon began to experience weakness in all four limbs, especially his legs, so clinicians conducted further testing. A magnetic imaging resonance (MRI) scan revealed that an area of the patient’s upper spine was slightly bruised as a result of injury-related swelling. He underwent intensive physical rehabilitation, and within a few weeks he showed no signs of weakness in his arms or legs.

Although most cases of SCI result from direct trauma to the spinal cord (and are typically irreversible), SCI is sometimes caused by injury to areas surrounding the spine, such as the neck or back. As a result, clinicians should be attentive to SCI-related outcomes like muscle weakness or paralysis, even when the spinal cord does exhibit direct damage. Therapeutic interventions and rehabilitation strategies can significantly improve outcomes, so early detection of indirect SCI is critical for ensuring that patients return to a high quality of life.

Khan K, Dieudonne B, Saeed S, et al. Paraplegia following spinal cord contusion from an indirect gunshot injury. Korean Journal of Neurotrauma. (April 2018).

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