New England Journal of Medicine
This image shows the bullet that was lodged in an 85-year-old man's head -- specifically, his foraman magnum -- for more than 80 years.
When a Russian man was only 3, his older brother accidentally shot him with a pistol. More than eight decades later, the bullet was still there, according to a case report just published online in the latest issue of the New England Journal of Medicine.
The bullet hit the little boy right below the nose and eventually lodged itself in his foramen magnum, the opening in the bottom of the skull that allows the spinal cord to pass through and connect to the brain. The 3-year-old lost consciousness for several hours. At the time, a doctor examined the poor kid, but didn't remove the bullet for fear of causing more harm than good, says Dr. Marat Ezhov of Moscow's Cardiology Research Center, who examined the patient more than 80 years later. Incredibly, the boy recovered completely.
"The body has an amazing ability to 'get used to' things," explains Dr. Richard O'Brien, a spokesman for the American College of Emergency Physicians. "Also, children have a great ability to overcome hardship and rebuild themselves when injured."
Eighty-two years later, Ezhov and Dr. Maya Safarova were treating the man at the cardiology center for his coronary heart disease. His patient history included the story of the accidental shooting, so doctors did a CT scan to check it out, which revealed the stowaway bullet. But the bullet had left no sign of neural damage -- further evidenced by the man's successful career as an award-winning engineer.
"High-speed missiles, like a bullet, can cause great damage and usually do," explains Dr. David Ross, an emergency physician at Penrose Hospital in Colorado Springs, Colo. "However, because they are high-speed, they generate a lot of heat. That heat usually means the missile is sterile -- meaning it is unlikely to serve as a basis for infection if it stays in one place for many years. So if it did not cause much damage, which it apparently didn't, it was unlikely to cause him ongoing troubles."
A weird little detail: Ezhov notes that the during his engineering career, the man oversaw construction of ballistic missles.
Doctors at the Russian cardiology center decided that at this point, the bullet didn't need to be removed -- after all, he was in good condition, Ezhov noted, and he had been doing well for decades. Besides, even his scar wasn't affecting his life negatively -- the bullet did leave a scar under his nose, but his curved, Roman nose keeps it invisible, Safarova said in an email.
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