1342. Symptomatic Vasospasm following Intracranial Penetrating Injury from a BB Gun in a Child

Authors: Alysa Almojuela; Demitre Serletis (Winnipeg, Canada)


BB guns or non-powder guns created in the modern era are able to reach exceedingly fast velocities as a result of advances in compressed-gas technology, yet their purchase, possession and distribution is unregulated in some cities. While missile penetrating intracranial trauma has been well documented in neurosurgical literature, injury secondary to non-powder guns, along with their associated vascular complications and treatments, is not well described.


Here, we review a case of a 6 year old child who was accidentally shot with a BB gun to the head.


Although initially stable, the patient subsequently experienced symptomatic vasospasm due to intracranial vascular injury. His symptoms, which consisted of right sided weakness, improved with hypertensive therapy, balloon angioplasty of the affected vessels and intra-arterial milrinone therapy.


This case highlights the unique complication of symptomatic vasospasm in a child following non-missile intracranial penetrating injury. This complication needs to be considered in the presence of a delayed neurological deficit given its potential reversibility. This case also emphasizes the importance of gun safety and education when handling non-powder guns around children.