Penetrating head injuries in children due to BB and pellet guns: a poorly recognized public health risk.
OBJECT Nonpowder guns, defined as spring- or gas-powered BB or pellet guns, can be dangerous weapons that are often marketed to children. In recent decades, advances in compressed-gas technology have led to a significant increase in the power and muzzle velocity of these weapons. The risk of intracranial injury in children due to nonpowder weapons is poorly documented. METHODS A retrospective review was conducted at 3 institutions studying children 16 years or younger who had intracranial injuries secondary to nonpowder guns. RESULTS The authors reviewed 14 cases of intracranial injury in children from 3 institutions. Eleven (79%) of the 14 children were injured by BB guns, while 3 (21%) were injured by pellet guns. In 10 (71%) children, the injury was accidental. There was 1 recognized assault, but there were no suicide attempts; in the remaining 3 patients, the intention was indeterminate. There were no mortalities among the patients in this series. Ten (71%) of the children required operative intervention, and 6 (43%) were left with permanent neurological injuries, including epilepsy, cognitive deficits, hydrocephalus, diplopia, visual field cut, and blindness. CONCLUSIONS Nonpowder guns are weapons with the ability to penetrate a child's skull and brain. Awareness should be raised among parents, children, and policy makers as to the risk posed by these weapons.
Department of Neurosurgery, Mayo Clinic, Rochester, Minnesota.
Ravi
R
Kumar
Department of Neurosurgery, Children's Hospital Colorado, Aurora, Colorado; and.
Ramesh
R
Kumar
Department of Neurosurgery, Mayo Clinic, Rochester, Minnesota.
Grant W
GW
Mallory
Department of Neurosurgery, Mayo Clinic, Rochester, Minnesota.
Jeffrey T
JT
Jacob
Department of Neurosurgery, Mayo Clinic, Rochester, Minnesota.
David J
DJ
Daniels
Department of Neurosurgery, Mayo Clinic, Rochester, Minnesota.
Nicholas M
NM
Wetjen
Department of Neurosurgery, Children's Hospital of Wisconsin, Milwaukee, Wisconsin.
Andrew B
AB
Foy
Department of Neurosurgery, Children's Hospital Colorado, Aurora, Colorado; and.
Brent R
BR
O'Neill
Department of Neurosurgery, Mayo Clinic, Rochester, Minnesota.
Michelle J
MJ
Clarke
ASTM = American Society for Testing and Materials; ATF = Bureau of Alcohol, Tobacco, Firearms, and Explosives; BB gun; CPSC = Consumer Product Safety Commission; ED = energy density; GCS = Glasgow Coma Scale; air gun; air rifle; brain injury; children; fps = feet per second; gunshot; head injury; pellet gun; trauma