Doctor: How Florida teen survived spear gun injury through the brain

A Florida teenager is on the road to recovery after being impaled with a 3-foot long spear that cut through his skull and brain.

Yasser Lopez, 16, was spear fishing with a friend June 8 when his friend accidentally shot him while loading the gun.  The spear entered Lopez’s skull above his right eye, penetrated his brain, and exited through the back of his head.

Miraculously, doctors reported Monday that Lopez survived the injury – and the subsequent three-hour surgery at Jackson Memorial Hospital in Miami – and is on his way to an intensive rehabilitation program.

“It’s a wild story and not as uncommon as you think,” Dr. Anders Cohen, chief of neurosurgery at The Brooklyn Hospital Center, told  “I’ve seen people come into the hospital with gun shots, knives, baseball bats and machetes in their heads.  You name it, I’ve seen it.”

When a patient first comes in with this type of injury, Cohen said doctors first have to assess the clinical state of the patient, as well as the anatomical location of the injury in the brain.

“In [Lopez’s] case, he had two good things going for him when he first came in,” said Cohen, who did not treat Lopez.  “First, he was awake and following commands, which allowed doctors to get a good neurological assessment.  Many people with these injuries are in a coma or deeply affected by their injury.”

The second promising factor, according to Cohen, was the location of the injury.  “From a neurological perspective, there were three things in his favor.  My catchphrase in terms of brain injuries is always location, location, location.  It’s like real estate.”

Because the spear cut through the right side of the brain, Lopez’s outlook is much more promising than if it had entered the left side, which controls cognition, speech and personality.

“The right frontal lobe (in the front of the brain) is silent; it probably doesn’t control much,” Cohen said.  “And then, if you look at the picture, in the back, the spear goes up near or through the motor strip of the brain.”

According to Cohen, assuming that Lopez is right-handed, this will likely only lead to some weakness or sensory issues on the left side of his body.  With therapy, he stands a good chance of making a significant recovery – possibly up to 70 or even 90 percent.

“The second thing is the spear didn’t cross the midline of the brain, which contains a lot of blood vessels and vital structures,” Cohen said.  “That would have made his odds of recovery much worse.”

Finally, the third neurological aspect in Lopez’s favor was that the spear missed all major blood vessels, so he didn’t suffer a major bleed or stroke.

“It was literally millimeters of margin of error,” Cohen said.  “He’s the lucky of the unlucky in terms of this injury.  If you’re going to get shot in the head, you’d want it to be on the right side, not crossing the midline and missing all of the major bloodlines.”

“Also the fact that he’s young and healthy means he has a better healing capacity,” Cohen added.

After removing the spear, another worry with these types of injuries is infection, which could lead to an abscess in the brain. Lopez’s doctors no doubt inundated him with antibiotics to counteract the bacteria on the spear, according to Cohen.

Finally, though Lopez reportedly does not remember the accident, Cohen said this is likely due to “post traumatic stress or being shell-shocked – it shouldn’t be attributed to the injury.”

“A good friend of mine is an attending at Jackson Memorial and says the doctors are impressed with how [Lopez] has done so far,” Cohen said.  “I have a cautious optimism for this boy’s injury.”