Gun shot wounds to the brain are among the most devastating causes of morbi
dity and mortality in the civilian population. The majority of the victims
will nor survive and for a great number of survivors life becomes an uphill
battle with permanent deficits and complications. While the fundamental su
rgical care of these patients is essentially unchanged, our scientific unde
rstanding of the pathophysiological changes and the post-injury care of the
victims has been evolving. The purpose of this article is to provide an ov
erview of the current clinical and laboratory advances in understanding and
treating gun shot injuries to the brain.