Civilian Gunshot Wounds to The Head: A Case Report, Clinical Management, and Literature Review.

Abstract

Background: Civilian Gunshot wounds to the head refers to the brain injury caused by projectiles such as gun projectiles and various fragments generated by explosives, gunpowder, etc. as a power launch or explosion. Gunshot wounds to the head is the deadliest of all gun injuries, according to literature statistics, the survival rate is only 9%.1 Due to the strict management of various types of firearms, they rarely occur, so the injury mechanism, injury and trauma analysis, clinical management, and surgical standards are almost based on military experience, and there are few related reports especially the head suffered a fatal blow more than once in a short time. We report a case with a return to almost complete recovery despite the patient suffered shots on the head twice in a short period of time.Case Presentations: We present a case of a 53-year old male who suffered twice gunshot injuries to the head under unknown circumstances. On initial presentation the patient had a Glasgow Coma Score of 6, unable to communicate, loss of consciousness. The first bullet penetrated from the right frontal area and finally reached the right occipital lobe. When the patient subconsciously covers his head with his hand, the second bullet through the patient's right palm bone, entered from the right frontotemporal, and stayed deep in the lateral sulcus. The patient had a cerebral hernia when he was admitted to the hospital, and immediately entered the operating room for rescue after a compute tomography scan. After two foreign body removals and one skull repair, the patient recovered completely.Conclusions: Gunshot wounds to the head have a high mortality rate and usually require aggressive management. Evaluation of most gunshot injuries requires extremely fast imaging examination upon arrival at the hospital followed by proactive treatment against infection, seizure and increased intracranial pressure. Surgical intervention is usually necessary, and its key point usually includes the timing of the operation, the method of operation, and the scope of the operation.

Gunshot wound to the lumber spine – Autopsy based case report

“…Evaluation of most gunshot injuries requires extremely fast imaging examination upon arrival at the hospital, followed by proactive treatment against infection, seizure, and increased intracranial pressure. 5 The firearm injuries need correct evaluation of entry or exit wounds. 1 The systematic study of bullet entry and exit wounds helped to establish the possible position of shooter and direction of firing.…”

“…They became popular for hunting, self-defense and killing. [3][4][5] The autopsy surgeon during the examination of alleged death by firearm injuries has to have a profound knowledge about the type of firearms, wounds caused by them, and to provide evidence that could be useful in the court for justice. 6,7 Here we present a case where the death is by shooting from a pistol from a point blank range.…”