Citation

Martucciello G, Tripodi R. Lancet 2012; 379(9812): e19.

Copyright

(Copyright © 2012, Elsevier Publishing)

DOI

10.1016/S0140-6736(11)60703-4

PMID

22100855

Abstract

In 2003, after the second Gulf War, the authors were medical doctors at the humanitarian Mission of the Red Cross Field Hospital in Baghdad, Iraq. Our experience in the field indicated that civilians were at a high risk for injuries caused by stray bullets. Whilst we were attending an out-patient activity, we saw a 10-year old boy with a deep lesion of the skin in the left frontal-parietal area of his head caused by a stray bullet 2 months earlier. The bullet had entered the upper parietal portion of the skull (figures A, B). Clinical and neurological examination showed no deficit of power, cognition, sense of touch, or speech. Blood test results were unremarkable. The scalp wound showed signs of advanced secondary healing despite no surgical intervention (figure A). Paradoxically, radiograph of the head (figure B), and cranial CT (figure C) showed a deep subcortical position of the bullet inside the right temporal lobe of the boy's brain. The presumed course of this stray bullet may be explained either by ricocheting of the bullet from the inner table of the skull, or delayed sinking of the shrapnel, after crossing the midline, due to its weight and the elasticity of the white substance of the child brain. The risk of seizure predisposition and of a possible unexpected change in the clinical condition were appropriately explained.

Keywords: Celebratory Gunfire

Language: en

Keywords

Child; Humans; Male; Tomography, X-Ray Computed; Foreign Bodies/*diagnostic imaging; Head Injuries, Penetrating/*diagnosis; Temporal Lobe/diagnostic imaging; Wounds, Gunshot/*diagnosis