# Ricochet Penetrating Head Injury: A Case Report and Brief Review of the Literature

## TL;DR

This paper presents a rare case of a ricochet gunshot injury to the head and discusses surgical considerations for such injuries.

## Contribution

The paper contributes a detailed case report and literature review on the management of ricochet penetrating head injuries.

## Key findings

- The patient was hemodynamically stable and alert with a GCS score of 15/15 upon arrival.
- Surgical exploration and removal of accessible bullet fragments led to an uneventful recovery.
- The case emphasizes the need for careful neurosurgical decision-making in ricochet injuries.

## Abstract

Ricochet gunshot injuries to the head represent an uncommon form of penetrating cranial trauma requiring careful surgical decision-making. We report the case of a 28-year-old male who sustained a ricochet gunshot injury to the skull with an associated left-hand wound. He was transported to the emergency department by the Red Crescent and arrived hemodynamically stable, alert, and oriented, with a Glasgow Coma Scale score of 15/15. Surgical exploration and debridement were performed, and accessible bullet fragments were removed. The postoperative course was uneventful, and the patient was discharged in stable condition. This case highlights important neurosurgical considerations in the management of cranial ricochet injuries, particularly the balance between elevating the bone and preserving depressed fragments for potential tamponade. A brief review of the literature is included to contextualize management strategies and outcomes.