Neurosurgical considerations after bull goring during festivities in Spain and Latin America

Bullfighting is a highly popular activity during festivities in Spain and Latin America. A scientific society for bullfight injuries, Congreso Internacional de Cirugía Taurina, was founded on November 24, 1974, in recognition of the distinctive pattern of injury that results from bull goring, and a subspecialty of general surgical trauma with emphasis on the acute surgical management of bull-goring injuries has emerged. Injuries to the head and neck are less frequent than genitourinary, inguinal, and abdominal injuries, but are more severe and more likely to result in death. This report reviews the primary venues in which bull goring and associated injuries occur, including the bullfight and the running of the bulls. The biomechanics of the primary and secondary goring injuries are reviewed, with an emphasis on those with the potential to result in neurosurgical injuries. This results in a very unique and devastating pattern of injury that combines penetrating and blunt mechanisms and results in polytrauma. Neurosurgical expertise should be immediately available on-site in the event of a life-threatening neurological injury.