This type of traumatic injury occurs when an object penetrates the skull and damages the brain. One part of the brain may be damaged. Damage can also occur to a larger area of the brain. This is a serious, life-threatening injury. It requires emergency medical care.
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Penetrating brain injuries may be caused by any object or external force, such as:
Risk factors include:
A penetrating brain injury is very serious and can lead to death. Gunshot wounds to the head are often fatal. The symptoms, though, vary depending on what caused the injury and how severe it is. Symptoms may include:
Because of the severity of this kind of injury, the doctor will evaluate the person as quickly as possible in the emergency room. This may include:
Depending on the person’s condition, the following tests may be done:
The treatment plan depends on a number of factors, including the:
The hospital staff will first attempt to stabilize life. If there is bleeding, steps will be taken to stop the bleeding as quickly as possible. This may include doing emergency surgery. To help the person breathe, a tube may be placed down the throat and into the lungs. Also, fluids and blood will be given to keep the blood pressure stable.
Depending on the injury, a neurosurgeon (a doctor that specializes in brain and spinal cord surgery) may need to:
The doctor may also place monitoring devices in the brain to check the:
Seizures may occur after a traumatic brain injury. Because of this, the doctor may give anti-seizure medicines. Strong pain relieving medicines, like opioids, may be given through a vein in the arm.
After the condition has improved, the doctors will create a rehabilitation program that may include working with:
The goal is to help the person regain as much functioning as possible.
Here are ways to prevent this type of trauma to your brain:
You can also prevent brain injuries by getting help if you are in a violent environment.
American Academy of Neurology
Brain Injury Association of America
The Brain Injury Association of Canada
Ontario Brain Injury Association
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Cranial gunshot wound. New York Presbyterian Hospital website. Available at: http://nyp.org/health/cranial-gunshot-wounds.html . Accessed March 31, 2011.
Cranial gunshot wounds. University of California, Los Angeles Health System website. Available at: http://neurosurgery.ucla.edu/body.cfm?id=134 . Accessed March 31, 2011.
DynaMed Editorial Team. Traumatic brain injury. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed/what.php . Updated February 21, 2011. Accessed March 31, 2011.
Glasgow coma scale. University of North Carolina at Chapel Hill website. Available at: http://www.unc.edu/~rowlett/units/scales/glasgow.htm . Updated March 31, 2011.
Gossett C. Gunshot wounds: a primer. Temple College website. Available at: http://www.templejc.edu/dept/ems/Pdf/CE%20Articles/GUNSHOT.PDF . Accessed March 31, 2011.
Gunshot wound head trauma. American Association of Neurological Surgeons website. Available at: http://www.aans.org/en/Patient%20Information/Conditions%20and%20Treatments/Gunshot%20Wound%20Head%20Trauma.aspx . Accessed March 31, 2011.
Neff D. Closed head injury. EBSCO Health Library website. Available at: http://www.ebscohost.com/healthLibrary/ . Updated February 16, 2011. Accessed March 31, 2011.
Penetrating injury. Brain and Spinal Cord.org website. Available at: http://www.brainandspinalcord.org/traumatic-brain-injury-types/penetrating-brain-injury/index.html . Accessed March 31, 2011.
Salisbury D, Novack T, Brunner R. TBI inform—traumatic brain injury caused by violence. Traumatic Brain Injury Model System website. Available at: http://main.uab.edu/tbi/show.asp?durki=85704 . Accessed March 31, 2011.
Treating trauma: what you need to know to save a life. Available at: http://webdoc.nyumc.org/nyumc/files/libra/u2/Treating_Trauma_Fall_06.pdf . Published 2006. Accessed March 31, 2011.
Understanding TBI. Virginia Commonwealth University website. Available at: http://www.tbi.pmr.vcu.edu/FactSheets/Understanding_Part1.pdf . Updated February 8, 2010. Accessed March 31, 2011.
What is brain injury? Brain Injury Association of Utah website. Available at: http://www.biau.org/what/what.html . Accessed March 31, 2011.
Last reviewed June 2012 by Igor Puzanov, MD
Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.
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