title: Bihemispheric gunshot wounds: survival and long-term neuropsychological follow-up of three siblings.
abstract: OBJECTIVE
  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.
  
  
  METHODS
  A retrospective chart review of available medical records and outcomes from standardized, validated psychological instruments was undertaken, summarized, and evaluated.
  
  
  RESULTS
  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.
  
  
  CONCLUSIONS
  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.
authors.affiliation: Department of Neurosurgery, The University of Alabama at Birmingham, 1720 2nd Ave S, Birmingham, AL, 35294, USA, agordon@uabmc.edu.
authors.forename: Amber S
authors.initials: AS
authors.lastname: Gordon
authors.forename: Nancy
authors.initials: N
authors.lastname: Tofil
authors.forename: Daniel
authors.initials: D
authors.lastname: Marullo
authors.forename: Jeffrey P
authors.initials: JP
authors.lastname: Blount
mesh_terms: D002648:Child; D002675:Child, Preschool; D003072:Cognition Disorders / Q000175:diagnosis / Q000209:etiology*; D005260:Female; D015600:Glasgow Coma Scale; D006801:Humans; D007223:Infant; D008137:Longitudinal Studies; D008297:Male; D009483:Neuropsychological Tests; D012189:Retrospective Studies; D035781:Siblings; D013534:Survival; D015898:Tomography Scanners, X-Ray Computed; D014948:Wounds, Gunshot / Q000150:complications*