A headshot from a revolver is hardly an insignificant incident. But in 1875, a medical record tells the unusual story of a patient who managed to walk home and talk to his family right after being shot in the forehead.
Accident? Alas, the report is not so detailed that today we will accurately answer this question, but we know that …
… The patient received a bullet in the forehead from a Smith & Wesson revolver pistol. The shot was fired from a distance of no more than 2 meters. The bullet caliber was 0.22 inches (or 5.6 mm). The bullet hit the right side of the forehead. After the bullet hit the forehead, the man fell and almost immediately lost consciousness. The man who fired a bullet at him considered that he had achieved his goal, left the victim alone and left the scene of the crime …
… When the man regained consciousness, as it is supposed, he was only embarrassed by the feeling of physical trauma, he got up, collected the keys and left the office, locking the door behind him …
Which is good if you've just been shot in the head.
… While the patient was walking towards the bathroom, he felt something dripping down his face. He unlocked the door, went to the mirror, and found a wound on his forehead. Still in a confused state of mind, he washed his face, locked the door, and headed towards the house, almost a kilometer from the place of work …
I remembered! I was shot in the head. Well, it’s better to go home …”- he probably thought.
… The patient walked this kilometer, through a densely populated street, holding a handkerchief on his forehead. When he got home, he sat down and said to his daughter: "Help me take off my clothes and go for a doctor."
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He told his wife that he fell and hurt his forehead …
… It is not clear whether he really could not remember what happened to him, or simply did not want to bother his wife, but after half an hour I was with him. He was conscious, thought reasonably rationally and did not feel pain. There was some kind of exhaustion on his face, but after drinking a little brandy on his face his mood lifted and a healthy blush appeared on his cheeks …
It is doubtful that such a small amount of cognac would have much of an effect other than perhaps improving the patient's mood.
… A few drops of blood oozed from the wound, which is a perfect hole with clean edges. With great care and delicacy, I introduced the silver probe through the soft parts, and then, with a slight inner twist, inserted it into the cranial cavity. The direction of the probe was mainly directed towards the back of the skull, with a slight upward and inward twist. The umbrella moved 2 inches deep, where it met the resistance of an elastic body …
A risky procedure. What was the doctor trying to achieve by inserting a metal instrument into a person's skull and directing it directly into the brain? Perhaps he was hoping he would find the bullet and then be able to extract it with forceps? Tough tough guys …
… Remaining in the wound, I felt a light and regular vibration. The pulse was seventy-two beats per minute, and the only common symptom that indicated injury was a palpable effort in speaking. Vision, hearing, smell and response to external stimuli remained ideal. There were no signs of paralysis or seizures. Perfect silence is prescribed, sometimes a tablespoon of milk, hot things for the legs and a cool, damp cloth for the forehead. Stimulants and other foods were temporarily banned.
Dr. Mayer invited two distinguished surgeons to examine his patient, but both agreed that surgery to remove the bullet would be too risky. All one could do was watch and wait.
… Until the sixth day, there were no changes in the patient's condition. The pulse remained at seventy-two beats per minute, the patient stated that he was comfortable, and, apart from some prostration and slight uneven speech, there were no general signs of trauma. The first recommendations were strictly followed. The wound was kept open, where a wax stick was injected several times a day, up to an inch deep …
Most likely the doctors disinfected the wound with the help of wax sticks and hoped that the bullet itself would find a way out of the head.
A week after the incident, the situation changed dramatically.
… From the sixth to the ninth day, the patient's speech became more and more indistinct, and the pulse rose to eighty. On the tenth day, the patient could hardly speak, and he also lost the ability to swallow. They decided to puncture the wound, as the patient complained of soreness in its vicinity. The patient slept a lot during the day. On the tenth night, he had slight convulsions, after which the right side of his face was slightly immobilized. Two more convulsions followed in the morning …
Bad sign indicating neurological injury.
… An ice pack was placed on the patient's head and the previous treatment continued. The next day (twelfth), the patient was completely speechless, which meant that he had a headache. There was a slight deformation on the face. The bandage was removed from his forehead. Creamy pus gushed from the wound …
… Later that day, discharge of purulent substances from the wound was observed. It seemed to be related to relieving pressure in the head.
It is quite plausible. Intracranial pressure is one of the main dangers of traumatic brain injury: edema (or, in this case, infection) can compress and damage sensitive brain tissue.
… The next day the patient began to speak, but very indistinctly. The pulse dropped to sixty. The patient was fully conscious. The wound remained open, but there was no more pus. Later in the morning, six leeches were applied to the forehead, the leech bites continued to bleed for about three hours …
… Except for one minor relapse, there was a stable, slow, but positive dynamics, and soon the patient demanded more solid food … In the second half of the twenty-first day, the patient overcame weakness … A few teaspoons of whiskey eased this condition, and now, with a steady pulse, in the region of seventy, the patient made great strides in the recovery process. He spoke clearly, was very cheerful, read the newspapers and insisted on handing out instructions on his business …
… By early May, six weeks after the accident, the patient was taking regular walks with a friend.
Soon he was discharged. He began to use the car regularly and returned to his full responsibilities, both in his business and in the societies of which he is a member. He currently claims to be perfectly healthy, with this exception. Once he had difficulty remembering a specific fact and a new word. Also, memories of the incident were erased from his memory.
Minor memory loss is a fairly common effect after traumatic brain injury. Nevertheless, given all this, the patient's recovery can be called a pretty good result, given the fact that a.22 caliber bullet is hidden in his skull. One positive effect was also noted - the man's digestion improved.
