History and evidence regarding hydrostatic shock

TL;DR

This paper reviews the historical development and scientific evidence for hydrostatic shock, a remote tissue injury caused by ballistic pressure waves, highlighting its controversial status and recent experimental support.

Contribution

It provides a comprehensive review of the history, evidence, and scientific understanding of hydrostatic shock in ballistic injuries.

Findings

Historical references to hydrostatic shock date to the 19th century

Recent experimental and medical evidence supports the existence of remote tissue injury

Controversy persists among medical professionals regarding hydrostatic shock

Abstract

This paper reviews the history and evidence related to remote wounding effects of ballistic pressure waves imparted to tissue by the impact of a bullet. Such remote effects are often referred to as hydraulic or hydrostatic shock. In spite of considerable published evidence and a long history, some medical professionals continue to regard the ability of a bullet to injure tissue that is not directly crushed or stretched as mythical (Jandial R, Reichwage B, Levy M, Duenas V, Sturdivan L. Ballistics for the neurosurgeon. Neurosurgery. 2008:62:472-480.) Early references to these effects date to the 19th century; however, compelling experimental support and medical findings in human case studies did not become available until the late 20th and early 21st century.