Ignatius N Esene, Ahmed M Ashour, Omar Youssef, Mohamed Wael Samir Mahmoud and Alaa Fahkr
Intraventricular migration of a pellet is an unusual complication of a gunshot missile injury to the brain. Herein, we report the case of a 58 year-old man with a gunshot pellet that migrated by its mere tiny size, weight and cerebrospinal fluid pulsation from the lateral ventricle through the third ventricle, aqueduct of Sylvius to the fourth ventricle without accompanying clinical nor radiological manifestations. The pellet was thus managed expectantly. The patient was closely followed-up for short term complications such as hydrocephalus, infection and in the long run will be monitored for syrinx. He remained symptom-free and serial CT brain till 6 months after injury revealed the pellet still lodged in the fourth ventricle. Instances of similar phenomena reported in the literature are also reviewed and discussed.
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