Neurobehavioral outcome after gunshot wounds to the head in adult civilians and children.

To assess the quality of long term outcome of civilian gunshot wounds to the head after intensive neurosurgical management, particularly with regard to the possibility of subtle problems due to diffuse injury, we administered neuropsychological tests to six survivors (four adults and two children) at about 1 year after injury. Five patients were moderately disabled, and one patient achieved a good recovery. Residual neurobehavioral sequelae were present in all cases. Defects in long term memory for new information were the most common sequelae, whereas the persistence of linguistic and visuospatial deficits was related to the hemispheric lateralization of injury. In comparison with the outcome reported for patients with closed head injuries who had similar Glasgow coma scale scores, our patients exhibited more severe impairment due to significant focal brain injuries and less evidence of diffuse damage.