Gunshot wound to the head in pediatric patient. A case report and review of the literature

Background: Traumatic brain injury is a serious pathology around the world. Incidence has been reported close to 200 cases per 100.000 people worldwide. In Colombia, the burden of injuries impacts more in the economically active Head injury, pediatric neurosurgery, neurosurgery, traumatic brain injury, case report. male population between 12 and 45. The wounds caused by projectile’s guns are common in the daily practice of neurotrauma care, being aware of their high mortality. Gunshot wounds of the head are usually fatal and have poor neurological prognosis. Case presentation: This case details the presentation of a pediatric patient who entered a University Hospital in Colombia after suffering a gunshot wound in the skull. The patient was admitted in poor general conditions, stuporous, hypotensive and with active bleeding, with a gunshot injury in the right frontal region. The neurologic exam had a decreased mentality (Glasgow Coma Scale of 4 / 5), with right pupil of 2mm, non-reactive, left pupil 3mm, weakly reactive. A computed tomography showed the trajectory of the projectile, an intracranial hemorrhage, cerebral edema and deviation of the midline greater than 10mm. The patient was taken to surgery. A bilateral cranial decompression of the frontal, temporal, and parietal with debridement were performed, as a damage control procedure. Satisfactory neurological outcome. Conclusion: It is necessary to perform studies that support the scientific evidence on the best option for the management of penetrating gunshot wounds in the skull in the pediatric population.