Gunshot wounds to the head in an urban setting.

The literature reveals several ominous trends in firearm injuries in the United States. The crack epidemic of the mid-1980s, the increasing availability of handguns and more lethal weapons, and, particularly in Southern California, the rise of gang violence have all contributed significantly to this trend. Although the crack epidemic seems to have abated, the weapons it produced and the criminal elements it encouraged are still around. Many public health experts have advocated gun control as a means to stop this violence, and they have several compelling examples to justify their efforts. Gun control, however, is beyond the scope of this article. Neurosurgeons can have some effect at the local level on gang violence, however. The University of Southern California Department of Neurological Surgery has been working with the Think First Organization and Community Youth Gang Service Organization to reach out to children before they become involved with the gangs. These organizations are also working with the justice system to reform young people already involved with gangs. The hope is that these patterns of violence can be arrested on the community level.