Direct head injury caused by a tear gas cartridge. Questions on safety: A case report from Iraq and review of the literature

Introduction and background: Primary injuries from tear gas weapons include injuries to the visual and respiratory systems and skin. However, few studies have reported direct mechanical brain injuries from tear gas weapons.

Case report: A 27-year-old male presented to the emergency department of a neurosurgery teaching hospital in Baghdad, Iraq, with a penetrating head injury of unknown source.

Discussion: Tear gas weapons are considered safe, but tear gas exposure causes severe complications. Traumatic brain injuries as a direct effect of tear gas bombs are rarely reported in the literature. Tear gas cartridge injuries should be managed in the same manner as any penetrating brain injury, with appropriate neuromonitoring. This monitoring is crucial for the detection and prevention of secondary brain insults.

Conclusion: Emergency medicine specialists and neurosurgeons should be aware that tear gas weapons are not always safe, and they should anticipate chemical, thermal and mechanical side effects of tear gas weapons. The literature and our results suggest that these weapons should not be considered civil and harmless.