It is not always necessary to hit the brainstem

[DoomCry]

As the science that deals with ballistic trauma explains, instant death after a gunshot is possible even if the brainstem has not been touched in the slightest. For example, a fatal neurogenic reflex can occur after the gunshot, with strong stimulation of the vagus nerve and a very violent reaction of the sympathetic centers leading to an immediate reflex cardiac arrest, practically a short circuit. Secondly, there could be massive brain damage after the shot from the shock wave and cavitation typical in large calibers that cause a herniation of the brain towards the foramen magnum which then secondarily compresses the brainstem that had not been hit. Even if there were no herniation, an electrical disconnection could occur following the shot leading to a fulminant coma and total cessation of vital functions with an intact brainstem. another thing that can happen after the shot is an interruption of the higher centers of consciousness and coordination for example when the thalamus or basal ganglia are destroyed it also happens with the bilateral frontal lobes in this situation there is a profound loss of consciousness and a cardio respiratory death follows in a few seconds. the latter is not exactly instantaneous but it is so rapid that it is clinically indistinguishable from the instantaneous one. Then there are all the other deaths due to bleeding or suffocation from blood etc. always due to the shot but which are not instantaneous. Only 70% of immediate deaths after a pistol or rifle shot occur due to involvement of the brain stem the others occur for the reasons listed above.