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A 15 year old was brought to our emergency department with mild headache after having been shot at contact range with an air pistol. Examination revealed a circular entry wound of 1 cm on the forehead without a corresponding exit wound. Neurologically there were no focal signs. Skull x ray examination showed a radio-opaque foreign body in the frontal lobe. Computed tomography scan showed pellet fragments in the left frontal lobe with surrounding haemorrhage. The child was referred to the regional neurosurgeons for further management.
Air pistols are known to inflict potentially lethal injuries such as extensive brain damage, traumatic aneurysms, and penetrating injuries of the abdomen.1 There have been reported incidents of suicides and non-accidental injuries with air pistols.2 Shanon et al noted that 85% of the injuries, where the mode of injury was known, were self inflicted while playing with air guns; 12.7% of their patients had long term disabilities.3
Air pistols, despite their capacity to inflict hazardous injuries, are still used as toys and continue to be mishandled by children. Increased public awareness of the hazardous nature of air pistols is required to prevent their mishandling. Educating the public in appropriate handling and supervision of children while playing with these deceptively harmless but lethal toys combined with a stricter legislation could reduce the incidence of these injuries. Physicians should be aware that some of these patients may appear clinically stable with minimal external injuries and still have significant trauma to the internal organs.