Penetrating brain injury from an accidental air gun shot: a case report

Abstract

Background: Air gun shot injury is a gunshot wound from a pistol or rifle that fires a bullet. The most common part of the body that penetrates in air gunshot injuries is the head, especially the orbit. The majority of fatal cases have been reported to enter that location and commonly involve children and adults. This report presents an interesting point of air gunshot injuries with brain damage surgical management. Case Description: A 6-year-old boy got referred from other hospitals and came unconscious after being shot in the head by an air gun about eight hours before being admitted to the hospital with a range of about two meters. The patient was said to have accidentally been shot from the front of the head. The patient had a history of vomiting without a history of consciousness and seizure. On the primary survey, the airway, breathing, and circulation were clear, with a Glasgow Coma Scale (GCS) of 13. Based on the clinical examination and the result of the head CT scan, the patient was diagnosed with penetrating brain injury at the left parietal region, with multiple fragmented objects, intracerebral hemorrhage, and intraventricular hemorrhage. We then perform urgent surgery to debride and extract the bullet. There was no surgical morbidity in this patient, who was allowed to go home. Conclusion: Penetrating brain injuries resulting from air gunshot wounds require exceptional management. Early surgery to debride the wound with consideration of bullet extraction is needed to prevent further complications and for a better outcome for the patient.