Cavernous Sinus Syndrome and Traumatic Carotid-Cavernous Fistula Attributable to a Self-Inflicted BB Gunshot Injury

Abstract

Introduction: Ball bearing or “BB” guns are a class of gas- or spring-powered projectile weapons whose power and muzzle velocity are often underestimated by casual users and children. Present technology has advanced such that modern BB guns produce high velocity but small caliber ballistic injuries which can penetrate the intracranial space and cause focal central neurologic deficits. The small size of the projectile simultaneously complicates diagnosis and treatment, particularly if the entry wound is not appreciated by the layperson, resulting in delayed care. We report a unique case of cavernous sinus syndrome precipitated by a self-inflicted facial BB gunshot injury in a child.