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Brain injuries caused by airguns are serious. The optimal management is wound exploration, excision of contaminated tissues and removal of loose bone fragments. In addition, careful monitoring, prophylactic antibiotics and anticonvulsants are required. The outcome is dictated by the importance of the intracranial structures which the pellet transects and the development of complications. Removal of the pellet is desirable only if easily accessible. We report five cases, of which four survived without deficits and one remained severely handicapped.
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