Child's Nervous System

, Volume 30, Issue 9, pp 1589–1594

Bihemispheric gunshot wounds: survival and long-term neuropsychological follow-up of three siblings

  • Amber S. Gordon
  • Nancy Tofil
  • Daniel Marullo
  • Jeffrey P. Blount
Case Report

DOI: 10.1007/s00381-014-2429-0

Cite this article as:
Gordon, A.S., Tofil, N., Marullo, D. et al. Childs Nerv Syst (2014) 30: 1589. doi:10.1007/s00381-014-2429-0



Penetrating gunshot wounds to the head (GSWH) have notoriously poor outcomes with extremely high mortality. Long-term follow-up data of affected children is scant in the medical literature. This report summarizes clinical presentation, management, and long-term outcomes from three children who survived “execution style” frontal, bihemispheric gunshot wounds with no or minimal surgical intervention.


A retrospective chart review of available medical records and outcomes from standardized, validated psychological instruments was undertaken, summarized, and evaluated.


Despite bihemispheric injuries in each patient, no patient required operative intervention. Each child survived without readily evident neurologic impairment; however, the extent of impaired executive function varied widely, and severe disinhibition remains profoundly disabling in one survivor.


Bihemispheric penetrating gunshot injuries are not uniformly fatal and can occasionally be associated with long-term favorable survival; however, impaired executive function has significant potential to be profoundly disabling in these injuries.


Gunshot woundPediatricsLong-term outcome

Copyright information

© Springer-Verlag Berlin Heidelberg 2014

Authors and Affiliations

  • Amber S. Gordon
    • 1
    • 5
  • Nancy Tofil
    • 2
    • 5
  • Daniel Marullo
    • 3
    • 5
  • Jeffrey P. Blount
    • 4
    • 5
  1. 1.Department of NeurosurgeryThe University of Alabama at BirminghamBirminghamUSA
  2. 2.Division of Pediatric Critical Care Medicine, Department of PediatricsThe University of Alabama at BirminghamBirminghamUSA
  3. 3.Children’s Behavioral HealthChildren’s of AlabamaBirminghamUSA
  4. 4.Section of Pediatric Neurosurgery, Department of NeurosurgeryThe University of Alabama at BirminghamBirminghamUSA
  5. 5.Department of Pediatric Neurosurgery, Pediatric Critical Care Medicine and PsychologyChildren’s of Alabama and University of Alabama at BirminghamBirminghamUSA