Gunshot wounds to the head and neck in the pediatric population have b
ecome alarmingly common, They often result in death of the victim, dev
astate families, and inflict a considerable financial burden to hospit
als and society. We present a retrospective study of cases treated at
a level I trauma center in Houston, Texas, from July 1990 to July 1993
, We identified 115 cases of gunshot wounds in children, 32 of which w
ere exclusively confined to the head and neck region, There were 26 ma
le and 6 female patients, Ages ranged from 3 to 17 years, The cranial
cavity was involved in 13 cases, leading to 9 deaths and 1 institution
alization. The shootings took place at home in 11 cases, and they invo
lved play in 12 cases, The shooter was known to 11 of the victims, and
the wounds were self-inflicted in 7 cases. The most common type of we
apon was the .22 caliber pistol, which caused four of the deaths, Two
of our cases involved BE air rifles, one of which mandated a craniotom
y for the evacuation of an epidural hematoma. Our findings indicate th
at gunshot wounds to head and neck in children are in most instances p
reventable and result in high fatality rates because of common intracr
anial involvement, even when low-energy missiles are used.