• Furqan B Irfan, Rameez Ul Hassan, Rajesh Kumar, Zain Ali Bhutta, and Ehsan Bari.
• Department of Neurosurgery, Aga Khan University, Karachi, 74800, Sindh, Pakistan. furqan.irfan@gmail.com
• Childs Nerv Syst. 2010 Jan 1; 26 (1): 61-6.

IntroductionGunshot wounds (GSW) to the head are the most lethal form of trauma; unfortunately, the frequency of children being involved in such form of trauma is increasing at an alarming rate worldwide. We present our experience with four children from 2 to 3 years of age with craniocerebral GSW admitted to the neurosurgery service at a tertiary care hospital.MethodsFor this study, four children, 2 to 3 years old, injured solely from bullet injuries to the head were selected. Their history, arrival Glasgow Coma Scale (GCS), clinical presentation at the time of arrival in ER, radiological findings, management, and follow-up reviewed.ResultsOut of four children, only one did not survive. The bullet entrance wound was in the parietal region in robbery-related incidences, and, in three cases, the injury was bihemispheric. The time taken to reach the emergency department was less than 2 h for all patients except one. Of four patients, three presented with GCS between 3 and 5 while 1 presented with GCS well above ten.ConclusionOur results show that even in children presenting with low GCS<5, an early act of aggressive surgical intervention can prove to be a life-saving measure.

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