Doctors have revealed a bittersweet case of a man who survived a gunshot to the head at close range.
The 29-year-old farmer from the Greek island of Crete was shot with a pistol from a distance of about 10 meters.
The bullet shattered as it tore through the left hemisphere of his brain and was near the back of his skull.
An hour after he was shot, he was rushed to hospital in a “comatose state” while doctors performed emergency surgery to remove part of his skull to retrieve the bullet fragments. Some could not be extracted.
The photo above is a scan of the man’s skull, highlighting the path of the bullet (arrow) and the point where the bullet lodged (end of arrow).
It is estimated that less than three percent of people survive a gunshot wound to the head.
Of those, even fewer fully recover from their injuries and continue to live as they did before they got the shot.
Two and a half years after he was shot in the head, the man is still alive, but can no longer speak beyond “monosyllabic utterances” and struggles to understand complex language.
He also experiences involuntary spasms on the right side of his body and difficulty moving the muscles on the left side.
Nevertheless, researchers said he still has emotions and can express his desires with sounds and his facial muscles, such as wanting to go home.
Relatives also told doctors they were confident he remembered previous events, although no evidence of this was provided.
The bullet pierced the left side of his brain – which is involved in speech and language processing and controlling movements on the right side of the body.
The right side, which is involved in emotions and problem solving and movements on the left side, was unharmed.
These two scans, also revealed in the report, show the path of the bullet (left, black arrow) and also the point of entry of the bullet into the brain (right, black arrowhead).
The matter came to light in the American Journal of Case Reports by doctors from the General University Hospital of Heraklion, Greece.
It was not clear where the injury occurred or why the man was shot; whether it was an accident or a deliberate attack.
Unlike the rest of Greece, where strict gun laws almost completely block ownership, Crete has a strong gun ownership tradition – with one local report on the island saying: ‘Crete and guns go together’.
It was also reported that the man was right-handed and was shot with a bullet traveling at low speed – or at a speed less than 300 meters per second.
Most people shot in the head die almost immediately, either from shock or because critical functions are disrupted.
A part of the brain at the base controls actions such as breathing and heart rate, stopping them if it becomes damaged – and death follows shortly afterwards.
However, in rare cases, patients survive if damage to the brain does not affect critical structures and they receive prompt medical care.
This was the case in the patient who was injured in the left hemisphere of the brain, where the area was related to language but did not control critical bodily functions.
This means that it is possible to survive an injury to the area, although individuals will likely be disabled for the rest of their lives.
Doctors said they revealed the case to show how the brain can recover after an injury to the left hemisphere.
In this case, the man would have suffered extensive damage to the left brain and left hemisphere, which is related to controlling movements.
Doctors immediately stitched the wound and performed surgery to relieve pressure on the brain and remove fragments of the bullet.
This was done via an emergency craniectomy — an operation to remove part of the skull to relieve pressure on the brain.
He was hospitalized for two and a half months, during which time he also underwent cranioplasty – or partial skull reconstruction – before being transferred to a rehabilitation center for 18 months.
Two years after the injury, he was returned to the hospital for a check-up.
Doctors diagnosed him with severe global aphasia, or severe communication problems, which made it difficult for him to understand language.
But they did find that he could follow basic instructions, such as understanding which of the two people should hand a pen to after receiving instructions.
They also discovered that he could produce sounds in response to instructions or express emotions, such as the desire to go home.