Central cord syndrome from blast injury after gunshot wound to the spine: a case report and a review of the literature

Central Cord Syndrome (CCS) is the most common of the spinal cord injury syndromes. Few cases have been presented with gunshot wound (GSW) as a cause of a central cord syndrome, and none, to our knowledge, has been presented without any evidence of central canal bullet/bone fragments. A 27-year-old male suffered two close-range gunshot wounds, one to the left neck and one to the left shoulder. CT scan showed C5 spinous process fracture and paraspinal muscle hemorrhage without evidence of central canal stenosis or bullet/bone fragments. Four months post injury, the patient had almost full recovery with only left proximal arm and bilateral distal hand weakness.

• 1
  Only four cases of CCS caused by GSW have been reported in the literature. In all of the above-mentioned cases, there was radiological or surgical evidence of spinal canal bullet or bone fragments.
• 2
  GSW to the spine can cause direct or indirect injuries. Direct injuries result from the bullet nucleus, broken metallic or bone particles and disc material. Indirect injuries result from the hydrodynamic strike effect (blast wave or cavitation wave) that cause damage distant to the projectile trajectory.
• 3
  At 1-year follow-up, the patient showed full independence with minor deficits consistent with the proposed prognosis of most CCS.