Vertebral artery injury due to air rifle: A case report

INTRODUCTION: This case report presents a rare case of vertebral artery and spinal cord injury due to air rifle pellet. CASE PRESENTATION: A previously healthy 19-year-old male was shot on his left neck incidentally during recreational air rifle game. He was taken to the other hospital before being referred to our hospital. CLINICAL FINDINGS AND INVESTIGATIONS: The patient presented with total loss of motoric function on his left side of the body together with sensoric function on the contralateral side from the level of C5 and below. Signs of stroke were also spotted on the patient's face. The cervical plain radiograph and CT scan were carried out preoperatively to depict pellet fragments. Meanwhile, the CT angiography which was commenced postoperatively revealed the left vertebral artery injury. INTERVENTIONS: Surgery comprising of pellet fragments removal, decompression and posterior stabilization of the cervical spine was carried out to retrieve the pellet fragments, which were embedded at the posterior epidural space. RELEVANCE AND IMPACT: Our findings were consistent with the vertebral artery injury and Brown-Sequard syndrome. Hence, these clinical entities should be considered in the setting of penetrating cervical trauma.