Shotgun pellet embolization to the intracranial internal carotid artery: Report of a case and review of the literature

We report a patient with the angiographic diagnosis of embolization of a shotgun pellet from its presumed left internal carotid artery entry site to the ipsilateral intracranial internal carotid artery. Subsequently, a left middle cerebral artery territory infarct developed. Review of the literature reveals 30 previous reports of intracranial embolization of metallic missile fragments. Observations of patient demographics, foreign body type, embolization patterns, neurologic deficits and presentations, and patient evaluation and therapy are discussed.