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Can You Survive a Shot in the Head?

Published in Gunshot Survival 3 mins read

While incredibly rare, it is possible to survive a shot in the head, though the vast majority of such injuries are fatal.

A gunshot wound to the head is one of the most severe forms of traumatic brain injury (TBI), leading to devastating consequences. These injuries are a significant contributor to TBI-related deaths, accounting for an estimated 35% of all fatalities attributed to traumatic brain injury.

The Overwhelming Odds of Fatality

The statistics underscore the grim reality of these wounds:

  • Extremely High Mortality Rate: Approximately 90% of all gunshot wounds to the head prove fatal.
  • Pre-Hospital Deaths: A substantial number of victims succumb to their injuries before they can even reach a hospital for medical intervention.
  • Emergency Room Mortality: For the small percentage of individuals who do manage to survive the initial trauma and arrive at an emergency room, roughly 50% will die while receiving care.

This means that only a very small fraction of individuals who suffer a gunshot wound to the head ultimately survive.

Why Survival is So Unlikely

The brain is the control center of the body, and even minor damage can have profound effects. A bullet passing through the skull and brain tissue causes immense destruction due to several factors:

  • Direct Tissue Damage: The bullet itself tears through brain cells, blood vessels, and nerve pathways.
  • Secondary Injuries:
    • Swelling (Edema): The brain swells rapidly within the confined space of the skull, leading to increased intracranial pressure (ICP), which can compress vital brain structures and cut off blood flow.
    • Bleeding (Hemorrhage): Extensive bleeding within the brain or around it can form hematomas, further increasing pressure and damaging tissue.
    • Infection: The introduction of foreign material (bullet fragments, bone shards, external contaminants) can lead to severe infections like meningitis or brain abscesses.
  • Location of Injury: The specific area of the brain affected is crucial. Injuries to the brainstem, which controls vital functions like breathing and heart rate, are almost immediately fatal. Even non-fatal shots often lead to severe and permanent neurological deficits.

Factors Influencing Survival (When It Occurs)

While largely a matter of chance, the few cases of survival often depend on:

  • Trajectory of the Bullet: A bullet that only grazes the skull or passes through non-critical areas of the brain, causing minimal deep tissue damage, offers a slightly better, though still slim, chance.
  • Absence of Major Vessel Damage: Avoiding major arteries and veins can reduce life-threatening hemorrhaging.
  • Rapid Medical Response: Immediate access to advanced trauma care, including neurosurgical intervention, is critical for any chance of survival and managing secondary injuries.

Even for those who defy the odds and survive, the journey is often long and arduous, involving extensive rehabilitation and coping with lifelong disabilities such as paralysis, cognitive impairments, speech difficulties, or personality changes.

For more information on traumatic brain injuries, you can visit the American Association of Neurological Surgeons.