Historical Review of Traumatic Brain Injury Caused by Fishing Speargun & a New Suicide Case

BACKGROUND: Traumatic brain injury (TBI) is a severe neurosurgical emergency and a significant public health concern. Fishing spearguns TBIs are included in nonmissile injuries and have been implicated in only few cases of TBI in the past 68 years, mainly of accidental etiology. OBJECTIVE: To introduce a novel case report of a TBI in a 38-year-old man shot himself with a speargun in a suicide attempt and to present a thorough review of related case reports along with the management strategies, prognosis, and outcomes. METHODS: We conducted a literature review of case reports in accordance with the PRISMA guidelines, including incidents of TBI by speargun published in Pubmed, Scopus, and Web of Science until January 2024. RESULTS: A total of 22 publications, reporting 26 cases of speargun-related TBIs formulated the 27 investigated cases including the current patient which were used in this descriptive and inferential statistical analysis. Predominantly affecting males (88.89%) with a median age of 29 years, these injuries were primarily due to accidents (65.38%), with a noticeable shift towards suicide. Outcome variability ranged from intact recovery (48.15%) in majority of cases to a range of unfavorable outcomes. Significant factors impacting outcomes included initial GCS score <8, major initial CT head findings, and major complications. Survival analysis indicated early manifestation of unfavorable outcomes. CONCLUSIONS: In summary, the diverse presentation, management, outcomes and identified influencing factors highlight the complexity of managing speargun-related injuries, and the need for personalized approaches and further research to enhance care protocols.