title: Successful repair of a gunshot wound to the head with retained bullet in the torcular herophili.
abstract: BACKGROUND
  Nonlethal missile injuries to the dural venous sinus system are rare. To date successful repair of isolated penetrating injury to the torcular herophili has not been reported without significant associated morbidity. We report the case of a gunshot wound injury to the occipital region with retained bullet fragment in the confluence of the sinuses causing traumatic sinus venous thrombosis.
  
  
  METHODS
  Occipital and suboccipital craniotomy for removal of bullet in the torcula, repair of sinus defect, and repair of depressed skull bone fragments was performed.
  
  
  RESULTS
  The procedure resulted in restoration of proximal and distal flow across the dural sinus system and preservation of torcular sinus patency with excellent neurological outcome. Technical considerations in the repair of penetrating torcular injuries are discussed.
  
  
  CONCLUSIONS
  Gunshot wounds with retained bullet fragments in the torcula can be successfully repaired with preservation of neurological function after retrieval of metallic foreign body and restoration of venous sinus patency.
authors: Department of Neurosurgery, Stanford University School of Medicine, Stanford, California, USA.
authors: Katie L
authors: KL
authors: Pricola
authors: Hongyan
authors: H
authors: Zou
authors: Steven D
authors: SD
authors: Chang
mesh_terms: D003392:Cranial Sinuses / Q000000981:diagnostic imaging / Q000293:injuries / Q000601:surgery; D006259:Craniocerebral Trauma / Q000000981:diagnostic imaging / Q000601:surgery*; D015600:Glasgow Coma Scale; D006801:Humans; D008297:Male; D019635:Neurosurgical Procedures; D011182:Postoperative Care; D020127:Recovery of Function; D012851:Sinus Thrombosis, Intracranial / Q000209:etiology / Q000601:surgery; D014057:Tomography, X-Ray Computed; D014948:Wounds, Gunshot / Q000000981:diagnostic imaging / Q000601:surgery*; D055815:Young Adult