Pediatric craniocerebral wounds from plastic bullets: Prognostic implications, course, and outcome

Objective: To review our experience with craniocerebral injuries caused by plastic bullets, and to delineate prognostic factors for outcome. Design: Retrospective case series of 29 patients presenting with plastic bullet- induced craniocerebral lesions. Setting: Pediatric intensive care department of a tertiary care center. Measurements and Main Results: Outcome was poor in 10 patients, good in 11, and two and six patients were moderately and severely disabled, respectively. Statistical analysis showed prognostic significance of the admission Glasgow Coma Scale score, computed tomographic findings of intraventricular hemorrhage and midline shift, and metabolic studies including hypokalemia and hyperglycemia. Conclusions: Plastic bullet- induced craniocerebral injuries carry a lower morbidity and mortality rate compared with other gunshot wounds. However, plastic bullets do incur a significant risk of injury. Their use should be carefully regulated.