Tangential cranial gunshot wound in an infant in historical context: illustrative case

BACKGROUND: Military neurosurgeons have long known that tangential cranial gunshot wounds can be associated with intracranial complications out of proportion to the external appearance of the injury. This phenomenon seems not to have been described in infancy. OBSERVATIONS: An infant suffered a massive, acute subdural hemorrhage from a contralateral tangential gunshot wound that did not facture the skull. LESSONS: Similar to adults, infants are subject to catastrophic intracranial injury from gunshots that do not penetrate the skull. The nature of the injury in this case reflected distinctive aspects of the tissue characteristics and proportions of the infant head.