[Traumatic embolization of the middle cerebral artery].

Abstract

A 3 mm metallic particle, which had blasted during grinding operation, shot into the neck of a nine year old boy, penetrated into the common carotid artery and embolized the right middle cerebral artery. There had been no neurological symptoms until four days after the injury. Suddenly, a mild left side hemiparesis occurred with accentuation of the arm. The case illustrates an unusual penetration and intravascular migration of a foreign body. After the injury, penetration and subsequent peripheric embolisation can happen immediately, or as in our case within a short time after. Hence, the small particle may not be detected by a local radiogram, or may not be found on surgical exploration. Therefore, in all cases of neck wounds caused by low velocity injection of foreign bodies, radiological evaluation with skull-x-rays and a neurological examination should be done. If further special scans are required, these should be accomplished by axial computer tomography, because the metallic nature of the foreign bodies would prohibit the examination by magnetic resonance.