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A cranial gunshot wound is a penetrating (bullet enters the skull, but does not exit) or perforating (bullet enters and exits the skull) wound through the skull caused by a firearm. 

Gunshot wound to the head is the most lethal and leading cause of head injury worldwide. 

Diagnosis of Cranial gunshot wounds

An immediate and urgent computed tomography (CT) scan of the brain is the first thing done as soon as the patient reaches hospital. 

Treatment of Cranial gunshot wounds

Gunshot injury is an emergency condition that needs to be managed promptly. Although the chances of patient survival are very low but following line of treatment is generally performed: 

• Aggressively resuscitation

• Maintaining blood pressure and oxygen level 

• Surgery may be performed depending upon patient consciousness and degree of brainstem neurological function

• Craniotomy is performed in identified cases of hematoma to remove the clot

A fatal outcome is certain in patients with minimal evidence of brainstem function and no evidence of an intracranial hematoma. These patients are not aggressively treated due to the futility of the situation. 

In cases, where patient survives the initial gunshot wound, outcome of treatment depends upon the extent of injury and damage caused by it to the brain. Patient is admitted in the critical care unit for several weeks after the trauma so that proper treatment can be given and early recovery can happen. Most of the cases need rehabilitation to regain lost function or to adapt to permanent injuries. Eventually complete recovery could take from several months to several years.