Figure 6c. Gunshot injury to the neck. (a) Lateral radiograph of the neck shows a fracture of the mandible with adjacent bullet fragments (arrow) and a single large bullet fragment in front of the cervical spine. (b, c) Axial CT images obtained through the mandible (b) and just below the mandible (c) show that these are two separate injuries. The distribution of bone and bullet fragments (arrows in b) shows that the bullet that caused the mandibular fracture traveled from left to right. Vertebral fractures and lead in the spinal canal (straight arrow in c) indicate that the bullet (curved arrow in c) traveled through the spinal canal and vertebral body. The patient was intubated and pharmaceutically paralyzed when he arrived in the emergency department, and his quadriplegia was not suspected until these images were obtained.