Gravitational bullet injuries

Abstract

Gravitational bullet injuries, prevalent in the Middle East, particularly in Iraq, are a critical public health concern, often resulting from celebratory gunfire. In our Neurosurgery Teaching Hospital in Baghdad, we've observed that these injuries differ significantly from high-velocity gunshot wounds, characterized by lower velocity and energy due to air resistance and gravity. Unlike high-velocity bullets, gravitational bullets cause less bone fragmentation and radial brain damage. These bullets often end up on the tentorium or within the skull base, rarely transgressing the cerebellar tentorium on a vertical trajectory. We've also noticed that the pediatric population, particularly younger children, are more susceptible to these injuries due to their thinner cranial vertex, leading to more penetrating injuries and aggressive brain bleeding. Our observations underline the need for focused studies, awareness, regulation, and tailored management strategies to combat this overlooked issue.

Keywords

• Gravitational bullet injuries
• Traumatic brain Injury
• TBI
• Iraq
• craniocerebral falling bullet