Getting shot with a gun in the brain

Hello,

I wonder why the parts of brain not got shot does not continue to work when you get shot a with gun. This is, perhaps, pretty stupid and ignorant question. But, I couldn’t find any proper information through Googling. I am sorry to ask you such a question with gruesome nature. It seems, to me, the bullet only should an impact on the part that it goes through. Why do other parts stop functioning?

The short answer is your brain is delicate and now it has a giant hole in it.

In reality, people have survived gunshot wounds to the brain. Like that lady senator who got shot by that crazed gunman a few years ago. It all depends on what part is hit and how, the size and speed of the bullet, how quickly medical attention is available and other factors.

Some parts do keep working.

While we wait for the medical pros around here, there are three things I’d point to:

  1. the brain is interconnected - both neurons and blood vessels. If I blow up a bridge, it doesn’t matter if the rest of the highway still works or not - the key connection is broken and the traffic is stuck. Very few parts of the brain work entirely on their own, and the circulatory system is absolutely dependent on certain key pathways.
  2. shock. A bullet going through the brain creates shock waves that ripple through the tissue and may slam it against the skull. The brain has a consistency like Jell-o, so it’s not designed to handle that. Thus, damage can occur far away from the path of the bullet.
  3. bruising and swelling. Damage to one part of the brain can cause the entire brain to swell; this swelling can then cause damage just about anywhere.

The google terms you may be missing are hydrostatic pressure and temporary wound cavity.

this has some insight that may help

I’ve brought this up before, but never got an answer. I’ll give it another shot (pun intended). How did Phineas Gage even survive his injury, without the benefit of modern antibiotics and neurosurgical techniques? It really seems tantamount to a miracle to me, and wiki has nothing on the subject. This question has been driving me crazy for years.

You’re thinking of Gabrielle Giffords, a U.S. representative.

Gabby Giffords - Wikipedia

Jim Brady was shot in the head during an assassination attempt of President Reagan, but did not recover as fully as Giffords:

James Brady - Wikipedia

Not bullets, but massive head wounds survived:

Phineas Gage - Wikipedia

Brazil man survives steel rod through head - BBC News

Anecdotally, my uncle, who was a brain surgeon, operated on a stable hand who’d had his brain kicked partially out of his skull.

It all depends on how much damage is done.

A GSW to the brain has direct effects and indirect ones.

Depending on the ballistics surrounding the projectile, significant direct damage will occur to surrounding brain tissue from the shock wave which spreads out from the projectile path. Obviously tissue through which the projectile passes is also destroyed or torn or otherwise disrupted.

There are two major types of indirect effects I can think of.

First, this sort of trauma produces a secondary swelling of the brain tissue itself, into an enclosed cavity. We can do an assortment of things to help this, and this pressure is always monitored carefully. It’s not unusual to remove part of the skull and not replace it for some weeks, to allow for expansion of the brain. If the brain swells too much into an enclosed space, it’s blood supply is compromised. There is also a pressure increase which can occur from bleeding. Again, an enclosed space, so active bleeding compresses the brain either inside the brain or between the brain and the skull. We can usually fix this, but of course you sometimes damage some of the brain getting to an area of bleeding. Regardless, any secondary swelling is damaging to the brain even if you control it at a gross level. There are a bazillion little connections in there fairly delicately wired.

The second kind of indirect effect is disruption of pathways. The brain likes to talk to itself and is pretty interconnected, so you might have an effect over here that disrupts an entire process which might be considered to be located over there, but actually uses pathways and/or processing information located over here.

About your buddy Phineas. Back in the day when men were men, right, although I think I’ve read about primitive societies that went about chopping into skulls and the “patients” obviously survived based on the fact that the skulls had healed…

Anyway, a bar of iron (if I remember the story) punched through his frontal lobe. He ultimately did fine, except that he had some personality changes and I think he eventually checked out from seizures (a common sequela of brain trauma). Well, basically that’s a low velocity mechanical punch through the brain, and since he only lost tissue from a (reasonably) “silent” area, and didn’t croak from infection or hemorrhage, it’s a pretty simple explanation as to why he did “fine.” Of course, no part of the brain is actually silent (the 10% use assertion being a complete canard), so it’s better to say he didn’t lose anything real critical to seeming like he was a regular guy. I suspect someone meeting pre-accident Phineas might not be so impressed that post-accident Phineas was “normal” compared to the original.

That’s pretty cool. I’ve seen a few neat injuries myself, like most ER docs.

But of course we’d probably ask the critical follow up question: How’d the guy do?
I’ve operated on plenty of people who ended up dead or might-as-well-be-dead…

I’ve heard that open-wound trauma to the brain, like a gunshot, actually tends to have better results than closed-wound trauma, due to shocks inside the skull from the latter.

A traumatic injury that permits decompression of bleeding because the skull is disrupted might be an example of the kind of thing you are talking about.

For instance, if you have a serious closed head injury and tear an artery (or even a vein), there’s nowhere for the blood to go and so you can get serious secondary injury–even death-- until it is repaired. If an injury that was otherwise similar blew out part of the skull, you could get some degree of decompression and avoid this.

It’s otherwise difficult to make a generalization, and of course gun shot wounds should be avoided if possible. I’d rather have an ordinary closed head injury and good immediate care (which might include surgically removing part of the skull) than a penetrating wound, on average.

A bullet passing through the skull doesn’t just hollow out a nice, clean tube a few millimeters wide. As others have said the bullet creates shockwaves that compress and expand brain tissue, and will generally disrupt/destroy an area much wider than just the diameter of the bullet, possibly causing the skull to basically explode. In addition, depending on the type and speed of the bullet and the angle of impact, chunks of shrapnel, bits of skull, or even the intact bullet itself can ricochet around the cranial cavity like beans inside a maraca.

Gun in the brain? Sounds like a pretty cool accessory to have.

In that case, is it possible for animals to survive the captive bolt pistol meant to kill them during slaughter?

You’d have to say theoretically yes, except that they don’t get carried off to the ER afterward.:smiley:

Commander Andreysen agrees.

That’s a huge problem. Skull fragments flying around in the brain can do real damage in addition to the initial projectile. Hydrostatic shock also causes havoc in the delicate structures of the brain. To understand the effect of the shockwave watch a video like this. The bullet doesn’t just punch through with a nice clean hole, it makes quite a bit of mess on the way.

Yeah, but there is a downside.

Relating to this and another thread on radiation weapons, Anatoli Bugorski effectively had a hole drilled through his head by a high energy particle beam, straight through his brain. However, with the damage being primarily thermal and not physical, he survived with remarkably few consequences.

Si

It’s possible for a chicken to survive being decapitated.

http://www.miketheheadlesschicken.org/story.php

Yes, they can also survive the blades meant to kill them, and I think some animals survive electric shocks meant to stun them.

He survived, but I don’t know how well he functioned afterwards. Sadly my uncle is now dead or I’d ask.