Pediatric gunshot penetrating head injury: a case report with 2-year follow-up

Steven Tandean, Marsal Risfandi, Iskandar Japardi



Gunshot is a rare subset of penetrating head injury, and generally the victim dies before arriving at the hospital. This paper reported a case of an intracranial gunshot injury in a 12 year-old boy that was shot by his friend, whose primary intention was to play around, using a revolver. A missile projectile penetrated from mid frontal and came out from right occipital. Vital signs were stable with GCS 8 from physical examination. A rational management strategy should permit a good outcome. The only complications that occured were hydrocephalus, yet it was managed by VP–shunt. Skull defect was closed using titanium mesh. A two-year follow-up showed a good result. The patient was able to do daily activity and back to school again.


gunshot penetrating head injury; pediatric

Full Text:



  1. DeCuypere M, Muhlbauer MS, Boop FA, Klimo P. Pediatric intracranial gunshot wounds: The Memphis experience. J Neurosurg Pediatr. 2016;17:595–601.
  2. Lichte P, Oberbeck R, Binnebosel M, Wildenauer R, Pape H, Kobbe P. A civilian perspective on ballistic trauma and gunshot injuries. Scandinavian journal of trauma, resuscitation and emergency medicine. 2010;18:35–43.
  3. Van Wyck DW, Grant GA, Laskowitz DT. Penetrating traumatic brain injury: A review of current evaluation and management concepts. J Neurol Neurophysiol. 2015;6(6):336–43.
  4. Alexiou GA, Sfakianos G, Prodromou N. Pediatric head trauma. J Emerg Trauma Shock. 2011;4(3):403–8.
  5. Doan N, Nguyen HS, Patel M, Shabani S, Janich K, Montoure A. Management of gunshot wound to the head in pediatric population: Mini-Review. Ann Pediatr Child Health. 2016;4(3):1108–9.
  6. Bandt SK, Greenberg JK, Yarbrough CK, Schechtman KB, Limbrick DD, Leonard JR. Management of pediatric intracranial gunshot wounds: predictors of favorable clinical outcome and a new proposed treatment paradigm. J Neurosurg Pediatrics. 2012;10:511–7.
  7. Aarabi B, Armonda R, Bell RS, Stephens FL. Traumatic and penetrating head injuries. In: Winn HR, Bullock MR, Hovda DA, eds. Youmans neurological surgery. 6th eds. Philadelphia: Elsevier Saunders. 2011. p. 3453–64.
  8. Irfan FB, Hassan RU, Kumar R, Bhutta ZA, Bari E. Craniocerebral gunshot injuries in preschoolers. Childs Nerv Syst. 2010;26(1):61–6.
  9. Ding J, Guo Y, Tian H. The influence of decompressive craniectomy on the development of hydrocephalus: a review. Arq Neuropsiquiatr. 2014;72(9):715–20.
  10. Kurland DB, Khaladj-Ghom A, Stokum JA, Carusillo B, Karimy JK, Gerzanich V, et al. Complications associated with decompressive craniectomy: A systematic review. Neurocrit Care. 2015;23(2):292–304.
  11. De la Plata CM, Hart T, Hammond FM, Frol A, Hudak A, Harper CR, et al. Impact of age on long-term recovery from traumatic brain injury. Arch Phys Med Rehabil. 2008;89(5):896–903.
  12. Anderson V, Catroppa C, Morse S, Haritou F, Rosenfeld J. Functional plasticity or vulnerability after early brain injury? Pediatrics. 2005;116(6):1374–82.
  13. –Giza CC. Lasting effects of pediatric traumatic brain injury. Indian Journal of Neurotrauma. 2006;3(1):19–26.

Copyright (c) 2018 Steven Tandean

Creative Commons License
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.

All articles and issues in Medical Journal of Indonesia have unique DOI number registered in Crossref.
Unique Visitors