25% of people survive self-inflected gun shots to the head??

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25% of people survive self-inflected gun shots to the head??

#1  Postby rwatter » May 30, 2013 10:14 pm

I stumbled across this and don't understand it... I thought a gunshot to the head was game over. How do so many people survive it, and how do only 28 of 39 patients who died from it met the standard for brain death? If you're dead because of TBI, how does not that mean brain dead?

Sixty-six patients with gunshot wounds to the head, including 59 with intracranial involvement (43 male, average age 26 years) were seen during a 4-year period. Injuries were limited to the head in 50 of 59 patients. Overall mortality was 66 per cent. Predictors of mortality included Glasgow Coma Scale (GCS) of six or less (93%), self-inflicted gunshot wounds (75%), and computed tomography (CT) findings of bihemispheric injury (87%) or ventricular injury (82%). Of the 39 patients who died, 28 met standard criteria for brain death...

https://www.ncbi.nlm.nih.gov/pubmed/8239201


Science must be incredible because an "overall mortality of 66 per cent" for gun shots to the head make no sense to me.
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Re: 25% of people survive self-inflected gun shots to the head??

#2  Postby Weaver » May 30, 2013 11:03 pm

Not at all surprising - most people don't know how to aim for shit, and hitting the brain - particularly the important part of the brain, the brain stem - isn't the same as hitting the head.

Unfortunately, most of those who survive end up with severe disfigurement and impairment.
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Re: 25% of people survive self-inflected gun shots to the head??

#3  Postby Weaver » May 30, 2013 11:05 pm

As to the bit about brain death vs death - they were looking partly at organ procurement, so organ failure leading to death is in a different class than the case where the brain is dead but the rest of the body is ticking along a bit.
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Re: 25% of people survive self-inflected gun shots to the head??

#4  Postby rwatter » May 30, 2013 11:12 pm

Weaver wrote:Not at all surprising - most people don't know how to aim for shit, and hitting the brain - particularly the important part of the brain, the brain stem - isn't the same as hitting the head.

Unfortunately, most of those who survive end up with severe disfigurement and impairment.


I never thought about it, but that makes sense remembering lobotomy. So they basically end up doing a lobotomy? Man that sucks, but shouldn't they be put down? I mean for gods sakes, if they wanted to die before to the point they shot themselves in the head, they sure as hell would want to die after surviving it.
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Re: 25% of people survive self-inflected gun shots to the head??

#5  Postby Weaver » May 30, 2013 11:16 pm

Some end up with a lobotomy, some with simply a destroyed face. Yet others manage to skip the bullet off the skull in various ways.
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Re: 25% of people survive self-inflected gun shots to the head??

#6  Postby rwatter » May 30, 2013 11:24 pm

Weaver wrote:Some end up with a lobotomy, some with simply a destroyed face. Yet others manage to skip the bullet off the skull in various ways.


Saving someone with a destroyed face or the futunate ones who skip the bullet off the skull I can understand, but shouldn't shooting yourself in the head to the point you need a lobotomy imply the patient wanted to exercise his "do not resuscitate" right? This is with suicide; someone who is the victim of a shooting I can understand the grey area.
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Re: 25% of people survive self-inflected gun shots to the head??

#7  Postby Weaver » May 30, 2013 11:30 pm

Unless they've left specific, legally-acceptable documentation of a DNR, they will be treated if they survive. Assumptions of deliberate intent vs spur-of-the-moment decision shouldn't be made absent appropriate documentation.
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Re: 25% of people survive self-inflected gun shots to the head??

#8  Postby rwatter » May 30, 2013 11:56 pm

I guess requiring an official DNR makes sense... I always thought a bullet to the brain was instant death similar to the heart. Pretty crazy how tough the brain is. I learned something new, thanks :)
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Re: 25% of people survive self-inflected gun shots to the head??

#9  Postby Weaver » May 31, 2013 12:01 am

People survive being shot in the heart, too, and death from heart hits is rarely "instant" - it usually takes a measurable period up to about a half a minute on the outside. The only place one can reliably generate an "instant" death is by destroying the brain stem.

Guns are not the uber-reliable killers they are portrayed to be, - there is a LOT of variability in terminal ballistics. This is one of the things I'm very interested in, that I expect to keep learning more about as long as I live.
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Re: 25% of people survive self-inflected gun shots to the head??

#10  Postby rwatter » May 31, 2013 12:22 am

Weaver wrote:People survive being shot in the heart, too, and death from heart hits is rarely "instant" - it usually takes a measurable period up to about a half a minute on the outside. The only place one can reliably generate an "instant" death is by destroying the brain stem.

Guns are not the uber-reliable killers they are portrayed to be, - there is a LOT of variability in terminal ballistics. This is one of the things I'm very interested in, that I expect to keep learning more about as long as I live.


I just read a bit on wikipedia about the brain stem, and it says it regulates heart rate. So if the brain stem regulates things like heart rate, and breathing; what happens to the heart when someone is officially brain dead? I don't understand why the heart continues to beat, but you stop breathing, when both are dependent on the brain stem.
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Re: 25% of people survive self-inflected gun shots to the head??

#11  Postby Weaver » May 31, 2013 12:30 am

The heart has internal pacemakers which can keep it beating independent of brain activity. The brain stem has an over-riding regulatory function which adjusts the "natural" heart rate to match conditions imposed by activity, oxygenation, blood chemistry, etc.
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Re: 25% of people survive self-inflected gun shots to the head??

#12  Postby Weaver » May 31, 2013 12:33 am

Here's an example from a fish - starts beating outside the body after removal about 40 seconds in.

Warning - graphic contents of a fish being cleaned.
[youtube]http://www.youtube.com/watch?v=18FI_XFG8UE[/youtube]
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Re: 25% of people survive self-inflected gun shots to the head??

#13  Postby rwatter » May 31, 2013 12:46 am

Man that's pretty cool. Here is a disturbing video I saw a long time ago of a dogs head being kept alive, without a body.

Russian Dog Head Isolation Transplant
https://www.youtube.com/watch?v=R2BxGOdYm8U

That makes it seem like a brain transplant is something that is likely going to be possible in the future. Where "important" people who get fatal body injuries or are dying of cancer, could be transplanted in an organ donors entire body.
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Re: 25% of people survive self-inflected gun shots to the head??

#14  Postby orpheus » May 31, 2013 12:57 am

Weaver wrote:People survive being shot in the heart, too, and death from heart hits is rarely "instant" - it usually takes a measurable period up to about a half a minute on the outside. The only place one can reliably generate an "instant" death is by destroying the brain stem.

Guns are not the uber-reliable killers they are portrayed to be, - there is a LOT of variability in terminal ballistics. This is one of the things I'm very interested in, that I expect to keep learning more about as long as I live.


This is one reason I've always been puzzled by the firing squad custom of aiming for the heart. Isn't that less humane than the head? (Presumably with multiple marksmen firing at the head, instant (or very quick and relatively painless) death is more likely than with an amateur suicide attempt?)
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Re: 25% of people survive self-inflected gun shots to the head??

#15  Postby Animavore » May 31, 2013 1:19 am

I'm reminded of James Vance, a Judas Priest fan who thought the songs had suicidal subliminal messages (so the story goes). He and his friend decided to end themselves but Vance chickened out and pulled away at the last bit second. They tried reconstruct his face but as you can see it didn't turn out the best...



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He suffered further depression and killed himself later anyway.
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Re: 25% of people survive self-inflected gun shots to the head??

#16  Postby Animavore » May 31, 2013 1:26 am

Weaver wrote:People survive being shot in the heart, too, and death from heart hits is rarely "instant" - it usually takes a measurable period up to about a half a minute on the outside. The only place one can reliably generate an "instant" death is by destroying the brain stem.

Guns are not the uber-reliable killers they are portrayed to be, - there is a LOT of variability in terminal ballistics. This is one of the things I'm very interested in, that I expect to keep learning more about as long as I live.


I'm sure you've heard of Chris Ryan? In one of his fiction books (which are complete shite,unlike his non-fiction stuff) the protagonist has to shoot the enemy, who is holding a hostage at gun-point, through the brain stem for instant death, lest we get off a shot after being hit.

I guess you read the same manual :)
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Re: 25% of people survive self-inflected gun shots to the head??

#17  Postby laklak » May 31, 2013 3:32 am

Anybody know that stats on shotguns? I can't imagine surviving a 12 gauge in the mouth, particularly aimed towards the back of the throat. Heavy load should blow the whole back of the head and spinal cord apart.
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Re: 25% of people survive self-inflected gun shots to the head??

#18  Postby UtilityMonster » May 31, 2013 5:13 am

People who shoot themselves in the head but don't die should be euthanized.
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Re: 25% of people survive self-inflected gun shots to the head??

#19  Postby Weaver » May 31, 2013 7:02 am

orpheus wrote:
Weaver wrote:People survive being shot in the heart, too, and death from heart hits is rarely "instant" - it usually takes a measurable period up to about a half a minute on the outside. The only place one can reliably generate an "instant" death is by destroying the brain stem.

Guns are not the uber-reliable killers they are portrayed to be, - there is a LOT of variability in terminal ballistics. This is one of the things I'm very interested in, that I expect to keep learning more about as long as I live.


This is one reason I've always been puzzled by the firing squad custom of aiming for the heart. Isn't that less humane than the head? (Presumably with multiple marksmen firing at the head, instant (or very quick and relatively painless) death is more likely than with an amateur suicide attempt?)

Heart shots for firing squads are likely designed to deal with the feelings of the firing squad much more than the condemned man - saving them the visual of multiple head-shots as they continue past the execution.
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Re: 25% of people survive self-inflected gun shots to the head??

#20  Postby Weaver » May 31, 2013 7:02 am

Animavore wrote:
Weaver wrote:People survive being shot in the heart, too, and death from heart hits is rarely "instant" - it usually takes a measurable period up to about a half a minute on the outside. The only place one can reliably generate an "instant" death is by destroying the brain stem.

Guns are not the uber-reliable killers they are portrayed to be, - there is a LOT of variability in terminal ballistics. This is one of the things I'm very interested in, that I expect to keep learning more about as long as I live.


I'm sure you've heard of Chris Ryan? In one of his fiction books (which are complete shite,unlike his non-fiction stuff) the protagonist has to shoot the enemy, who is holding a hostage at gun-point, through the brain stem for instant death, lest we get off a shot after being hit.

I guess you read the same manual :)

Same manual? No - but it's not like this is restricted information.
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