Abstract：
BACKGROUND: Facial gunshot wounds have devastating functional and aesthetic consequences for the patient. If associated with penetrating craniocerebral injuries, the prognosis is rather compromised even with appropriate medical and surgical treatment. Chop-off injuries with penetrating wounds constitute a challenging situation for the facial reconstructive surgeon in facial trauma.
METHODS: This case involved a 49-year-old man who sustained an accidental facial shot from a pellet gun. Radiological and clinical investigations revealed complex ballistic trauma to the maxillofacial region, with projectiles reaching the base of the skull. One of the projectiles migrated via the carotid canal towards a cerebral artery, leading to obstruction of the artery with cerebral infarction. An autopsy was performed which evaluated that the shooting distance was compatible with a long distance, causing the dispersion of lead grains with the absence of a wad inside the trauma site.
CONCLUSIONS: In some cases of facial gunshot wounds, despite a complex and extensive lesion assessment, death may occur due to a neurological complication rather than sustaining hemodynamic shock, depending on the trajectory of the projectiles.
METHODS: This case involved a 49-year-old man who sustained an accidental facial shot from a pellet gun. Radiological and clinical investigations revealed complex ballistic trauma to the maxillofacial region, with projectiles reaching the base of the skull. One of the projectiles migrated via the carotid canal towards a cerebral artery, leading to obstruction of the artery with cerebral infarction. An autopsy was performed which evaluated that the shooting distance was compatible with a long distance, causing the dispersion of lead grains with the absence of a wad inside the trauma site.
CONCLUSIONS: In some cases of facial gunshot wounds, despite a complex and extensive lesion assessment, death may occur due to a neurological complication rather than sustaining hemodynamic shock, depending on the trajectory of the projectiles.
摘要：
背景：面部枪伤对患者具有破坏性的功能和美学后果。如果与穿透性颅脑损伤有关，即使采用适当的药物和手术治疗，预后也相当不利。具有穿透性伤口的斩断伤对于面部创伤中的面部重建外科医生构成了挑战性的情况。
方法：这起案件涉及一名49岁的男子，他被弹丸枪意外击中面部。放射学和临床研究显示，颌面部区域受到复杂的弹道创伤，射弹到达头骨底部.其中一枚弹丸通过颈动脉向大脑动脉迁移，导致动脉阻塞和脑梗塞。进行尸检，评估拍摄距离与长距离相符，在创伤部位没有一团的情况下导致铅粒分散。
结论：在某些面部枪伤病例中，尽管进行了复杂而广泛的病变评估，死亡可能是由于神经系统并发症，而不是持续的血流动力学休克，取决于弹丸的轨迹。
方法：这起案件涉及一名49岁的男子，他被弹丸枪意外击中面部。放射学和临床研究显示，颌面部区域受到复杂的弹道创伤，射弹到达头骨底部.其中一枚弹丸通过颈动脉向大脑动脉迁移，导致动脉阻塞和脑梗塞。进行尸检，评估拍摄距离与长距离相符，在创伤部位没有一团的情况下导致铅粒分散。
结论：在某些面部枪伤病例中，尽管进行了复杂而广泛的病变评估，死亡可能是由于神经系统并发症，而不是持续的血流动力学休克，取决于弹丸的轨迹。
