Abstract
Background Nonpowder firearms discharge a projectile using compressed gases. Unlike traditional firearms, there is a perception that nonpowder guns do not cause serious injury. However, intracranial injury disproportionally affects children and can cause significant neurological disabilities and mortality. Management of nonpowder firearm injuries has received little attention in the literature and presents unique surgical challenges. Materials and Methods We conducted a narrative review of the literature of the management of nonpowder firearm injuries with particular emphasis on intracranial injury. Results Modern nonpowder firearms have muzzle velocities which are capable of penetrating the skin, eyes, and bone. Direct intracranial injury commonly results from entrance of projectile through thinner portions of the skull. Operative intervention is needed to debride and safely explore the trajectory to remove fragments which can easily cause neurovascular injury. Conclusions Neurosurgeons play a crucial role in managing serious nonpowder firearm injuries. A multidisciplinary team is needed to manage the direct results of penetrating injury and long-term sequalae.
Highlights
Unlike traditional firearms which use gunpowder, nonpowder firearms are designed to discharge a projectile using kinetic energy derived from compressed air and carbon dioxide or using a spring mechanism. ese projectiles can be made of a variety of materials such as aluminium, lead, and plastic, and in a variety of shapes and sizes including spherical ball bearings (BB guns) and pellets
We present a review of the literature on the aetiology and neurosurgical management of nonpowder firearm cranial injuries
Singlecentre studies from the USA have shown that nonpowder firearm injuries were more likely to be unintentional and to affect a greater proportion of Caucasian patients compared to traditional firearm injuries [9, 10]
Summary
There is a perception that nonpowder guns do not cause serious injury. Intracranial injury disproportionally affects children and can cause significant neurological disabilities and mortality. Management of nonpowder firearm injuries has received little attention in the literature and presents unique surgical challenges. We conducted a narrative review of the literature of the management of nonpowder firearm injuries with particular emphasis on intracranial injury. Direct intracranial injury commonly results from entrance of projectile through thinner portions of the skull. Operative intervention is needed to debride and safely explore the trajectory to remove fragments which can cause neurovascular injury. Neurosurgeons play a crucial role in managing serious nonpowder firearm injuries. A multidisciplinary team is needed to manage the direct results of penetrating injury and long-term sequalae
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