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Thread: 24 y/o gsw victim

  1. #1

    24 y/o gsw victim

    On Saturday, 9/29/07 around 4am my little brother was at a club and was struck by a gunshot. His MRI report indicates fractures of the L1 right lamina and vertebral body in the AP plane as well as the vertebral body of T12. There is cord swelling and high signal indicating cord injury at those levels. There is an area of subarachnoid hemorrhage at the L2/L3 level. Ther final impression is that there T12 and L1 fractures with focal cord injury and subarachnoid hemorrhage. Pleural fluid. One physician stated that the MRI shows spinal cord compression and he is deliberating surgery. The other physician said based on the report it should just heal on its own. What do you suggest. Any advice would be appreciated. Thanks in advance!

  2. #2
    Where is your brother? Is this a major (ideally level 1) trauma center? What are the specialities of these two physicians? It is common that with a gun shot wound there can be significant cord damage without the bullet actually passing through the cord (this occurs from the shock wave and heat generated by the bullet), but there is often minimal vertebral damage. If there is cord compression by bone or disk, or if the vetebrae has an unstable injury (there are very specific criteria for this) then surgery is generally indicated.

    You did not mention anything about what amount of neurological deficit he is showing right now. Ask them for a current ASIA score and type. They should be telling you and him this from day one. It can change over time, so should be evaluated regularly during the first few days and weeks after injury.

    I am glad you found our forum. Please post any other questions you may have. It will be important that your brother get to the correct type of specialty SCI center ASAP. We can help direct you.

    (KLD)

  3. #3

    More Info

    His Asia score is a B. It is an incomplete injury. He has some sensation in his legs and his rectum has some tone and is not completely flaccid. The bullet did touch his spinal cord and the surgeon would like to "go in and make some room for the cord to heal." I hope this is enough info. They want to schedule surgery tomorrow.

  4. #4
    He is currently at Jacobi Medical Center which is a Level I Trauma Center but I won't comment on the care. The orthopedic surgeon is Dr. Nathaniel Tindel. The bullet did touch the cord but it did not go through it. They would like to remove pieces of the vertebrae in the spinal canal. They would also like to remove some of the blood surrounding the cord. The injury is stable.

  5. #5
    What plans are being made to move him to a major SCI center?

    Will he be in a back brace (TLS0) after the surgery? What type of stabilization are they planning?

    (KLD)

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