Chronic penetrating traumatic brain injury - intracranial bullet
Headache and dysarthria
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The inlet of a bullet is seen in the left parietal bone with few related intra-axial bone fragments. The bullet is settled anteriorly in the inter-hemispheric fissure.
No outlet noted.
A left frontoparietal linear track of CSF like density is seen along the bullet course, likely representing encephalomalacia.
Subsequent ex-vacuo dilatation of the left lateral ventricle is seen.
Few small radiodense objects/bone fragments are seen along the bullet course as well.
Paranasal sinus opacification noted.
On further inquiry, the patient claimed that there was an old history of a bullet injury, after which he developed these findings.