Metallic Foreign Body in the Neck – a Rare Incidence

Penetrating injuries of the neck comprise upto 10% of all cases of trauma.We report the case of a 19 years old female who was admitted in Neurosurgery department of Lahore General Hospital with complaints of upper and mid back pain for 3 weeks, numbness of legs, abdomen and chest for 2 weeks and weakness of  legs for 10 days. There was no preceeding history of trauma, major surgery or systemic illness. Her neurological examination suggested upper motor neuron signs in both lower limbs. She underwent a series of extensive investigations to rule out the differential diagnosis of myelitis, arteriovenous malformation and caries spine. In parallel to ongoing investigations, she received symptomatic treatment and empirical antituberculous therapy. Her MRI report showed a photon deficient area at the level of T1, which was also seen in chest Xray but was overlooked as artefact. Later on it was found to be a stray bullet which was causing the symptoms.