Dr. Knowledge didn't answer me :(

[Kiwi_love]

If one were to be shot through the head at point blank range, could the bullet pass directly between the two halves of the brain and come out the other side without resulting brain damage or death? I'm doing research for a novel.

[Abhijeet Deshmukh, MD]

Hi.

Sorry for the late reply.

Since he is in the operating room, there should be an on table X-ray to find out the bullet (if it is stuck inside). The x-ray will also tell which bones are broken.

The assistant doctors monitor the blood pressure, respiration and heart rate, while the primary surgeon prepares for the exploration. If the assistant doctors say that the condition is not stable, there are chance that the bullet has ruptured some blood vessel. His blood pressure will drop down. They can maintain it by blood transfusion.

There are other organs also which may get injured. Some of these are the esophagus, the lungs and the heart.

In the case of severe injuries, an exploratory thoracotomy will be done. The bullet has to be removed, with specific instruments (forceps). Something Mr Bean would do without!!!

Ruptured blood vessels will be stitched, bones will be fixed and the wound will be closed (or left open if the surgeon thinks so).

The patient will need respiratory support.

Hope this helps.

Regards

[Kiwi_love]

Ok, my main character got shot again, this time in the chest. Poor man.

What would the procedure be once he's in the operating room? Not in great detail, but just a basic outline.

[ggreg]

I've heard when blood mixes with the brain fluids, that is what is so damaging, at least with aneurysms.  I know nothing of the mechanism of gunshot wounds to the head.  Our ABC anchorman, when his skull was invaded by shrapnel, did fall down but stayed awake for a little while and talked.  I would very much like for you to investigate more about records of folks who walk into the emergency room with a bullet in the brain, for example... would lend so much authenticity and interest to your story.  There is a man who specializes in what firearm injuries do in regards to evidence, he wrote "The Evidence Never Lies," he will pry bullets out of trees, measure and inspect blood spatter, even fires weapons and I believe films the sequences, but that may be another person.  I'm a big help, aren't I.  Well, I'll jump off this hijacked train, I hope you find good info.  I always enjoy researching for stories.

[Kiwi_love]

Yeah he probably would be knocked out.

I've heard of Phineas Gage, he definitely got messed up. It impaired his reasoning. When a doctor told him he would buy a bag of marbles from him (as a test) for a lot of money, Gage got angry and refused. My character's going to have these massive headaches afterwards. I have no idea if that's realistic, but you'd think you'd have headaches after you're shot in the head.

[ggreg]

Just gotta jump in here.  I think I would MOST CERTAINLY be knocked out if someone shot ME in the head!  Ha!  Sorry, I'm a writer, too, can't help myself.  I have read somewhere or seen on TV about people surviving bullets going through their brain, in and out, sorry can't remember where, but seems like it stuck with me becuz they weren't too goofed up.  Then there's the famous story about the real man, I guess in the 1800s, Phineas Gage, who got a rod skewered in his head, and he was some kinda goofed up from that, but kept on living for a number of years.  At least give your guy a slight weakness, just to keep the tension going.  "April looked down at Phineas, still so handsome despite his crushing wound, blood-soaked sheets.  He woke up, his left eye startled her, instead of steel blue, now red ringed and runny."  Well, I'm no pro, as you can see.  Just wanted to have fun.

[Kiwi_love]

He's in a hotel, so he gets found pretty fast and brought to the hospital.

Would he be knocked out? It's kind of important that he be knocked out, for dramatic effect and so the shooter doesn't think he's not dead and shoot him again.

[Abhijeet Deshmukh, MD]

Hi.

Wish you a very Happy New Year.

Your lead role has to be taken to some medical care soon. He should not catch any infection of the brain as the wound has exposed his brain to the infectious agents outside.

Regards

[Kiwi_love]

Thank you for your reply, it was very helpful.

Yes it is the main character. I'm happy to know he's not going to die. ;)

[Abhijeet Deshmukh, MD]

Hello.

I am glad you are including scientifically correct events in your writing.

It is possible theoretically. The bullet may pass between the two cerebral hemispheres, with minimal damage. But it has to enter from the forehead in the centre, a little towards the hairline. There is a sheet of connective tissue membrane (quite thick) which separates the two hemispheres, called as Falx cerebri. The falx has in it, venous sinuses which run longitudinally. One lining the top and the others either at the floor or the sides of the skull. It may lead to some amount of bleeding from the venous sinuses. The person may survive the shot.

I have read about a case, where the bullet entered from the temple region of the skull nad was stuck 'inside' the brain. The patient was walking. The bullet was later removed surgically, after about a couple of months.

Hope this helps. I guess the person who is shot is the lead role !!?

Regards