What are some of the things that could happen if a person is shot in the back of the neck with a pistol?

Answer

Death may be unavoidable. Being paralyzed from the neck down is a definite possibility.

From a radiologist who has seen quite a few gunshots to the spine: Often the bullet will hit bone and either lodge there, or fragment with bits scattered through the soft tissues. If the bullet fragments or pieces of shattered bone make it into the spinal cord or nerve root the patient will receive neurological damage, but if not he, or she, may be asymptomatic. A lot depends on luck, but the caliber and velocity of the bullet must also be considered. A lot of handgun rounds are relatively low energy, and may be deflected or blocked by the bone. The average rifle round is unlikely to be so deflected, and would likely cause serious -- if not fatal -- damage.

Even if the bullet does not hit the spine, or shatter bone, it might still sever an artery or vein. The result, of course, is severe blood loss, often leading to death. If the bullet misses all three -- bone, spinal cord, and arteries/veins -- there is always muscle damage.

At the very least, anyone shot in the neck is going to be in a lot of pain.