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Shotgun embolus
  1. Fiona Katherine McCurdie1,
  2. David Cottrell2,
  3. Luke Bennetto2
  1. 1University of Bristol, School of Medicine, Bristol, UK
  2. 2Department of Neurology, Frenchay Hospital, Bristol , UK
  1. Correspondence to Dr Luke Bennetto, Department of Neurology, Frenchay Hospital, Bristol BS16 1LE, UK; luke.bennetto{at}nbt.nhs.uk

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A 67-year-old man presented with a three-month history of daily headaches in the left temporal region. He had been previously well and clinical examination was normal. Skull x-ray (figure 1) and CT scan of the head (figure 2) showed a metal dense pellet in the right middle cerebral artery. Chest x-ray showed at least 50 similar pellets in the thorax and neck (figure 3). Subsequent spiral CT scan of the chest (figure 4) to investigate later and unrelated complaints of shortness of breath showed many metal dense pellets in the superior mediastinum.

Figure 1

Skull x-ray AP and lateral …

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