Foreing body lodged in third ventricle, by pneumatic weapon without neurological damage to 12 year follow up. Case report

BACKGROUND: The projectile injuries of pneumatic weapons, due to their mechanics, can produce fatal injuries or with multiple sequels, mainly of the central nervous system. CLINICAL CASE: 8-year-old patient, who suffered an impact from a pneumatic projectile (5.5 mm caliber rifle), at a distance of approximately 15 cm from the face. He reported no loss of consciousness, seizures or vomiting, only pain and heavy bleeding at the site of entry of the object. Upon admission to the hospital, normal physiological constants were found. In the frontal region a circular wound was observed, with irregular edges of 6 mm. Skull x-rays showed a radiopaque foreign body lodged in the central part of the inside of the skull. Simple skull tomography reported an entry path in the left paramedian line, in addition to a rupture of the left lateral ventricle and accommodation of the foreign body in the third ventricle. The Neurosurgery team ruled out performing a surgical procedure, due to the location of the foreign body. The patient was hospitalized for 10 days, received treatment with ceftriaxone (100 mg/kg/day) for five days. He remained asymptomatic, with adequate healing of the entrance hole. In the last review, 12 years after the event, the physical and neurological examination did not report manifestations or complications. He is currently 20 years old and maintains a good state of health. CONCLUSIONS: It is necessary that "toy weapons" be labeled as dangerous items. It is recommended to adapt laws for the sale and use of pneumatic weapons.