Penetrating crainocerebral injuries are the leading cause of death from head trauma in the civilian population aged 35-75 years. Gunshot wounds of the head are on the increase, the easy availability of hand guns, shot guns and rifles demands a renewed and serious interest in and a better under standing characteristics and surgical pathology of missile wounds. Penetrating wounds of the head constitute a major clinical challenge for neurosurgeons dealing with trauma in both civilian and military practice.