Ballistic Analysis of Shotgun Injuries to the Central Nervous System

Sights, Warren P.

doi:10.3171/jns.1969.31.1.0025

Cited by 20 publications

(7 citation statements)

References 8 publications

(4 reference statements)

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“…Most of the patients presented with GCS range (9-12) 17 (44.7%) & (13-15) 16 (42.1%)while (5-8) 5 (13.2%), outcome of (13-15) group was the best (87.5%) and it is signi icant factor and has strong positive correlation with the outcome, which is comparable to the studies that showed a postresuscitation GCS score greater than 8was highly predictive of favorable outcome (Sights, 1969;Aarabi et al, 2014;Mark et al, 2010).…”

Section: Resultssupporting

confidence: 67%

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Factors affecting the outcome in surgically treated civilian penetrating head injury: Case series

Dolachee¹,

Lafta²,

Mohammed³

et al. 2019

ijrps

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Penetrating brain injury (PBI) is any injury that causes penetration of the scalp, skull, meninges, and brain. It is a traumatic brain injury caused by either low-velocity sharp objects (e.g. a knife), high-velocity projectiles (shell fragment or bullets) or blast injury is the consequence of the detonation of complex explosives with or without PBI and closed head injury. To evaluate the factors (pre-operative and operative) that affect the surgical outcome of civilian PBI. This study was done from February 2017 to October 2018 prospectively & retrospectively. The study involved only the civilian patients that got a penetrating head injury and surgically treated in Neurosurgical Teaching Hospital/Baghdad/Iraq. The data include thirty-nine (39) operated patients with PBI. Data information includes the Glasgow Coma Scale (GCS), radiological investigations (computerized tomov graphy (CT-scan) and plain X-ray) the outcome determined by Glasgow Outcome Score (GOS). The patients were followed up during the time of hospitalization. The surgical outcome of the penetrating head injury in this study was assessed by GOS and was as follow, good recovery 10 patients (25.6%), moderately disabled 11 patients (28.2%), severely disabled 5 patients (12.8%), vegetative 6 patients (15.4%), Dead 7 patients (18.0%). Good outcome 21 patients 53.8% while poor outcome 18 patients 46.2%. GCS is significant factor (p-value = 0.002), time not affecting, CT-finding is significant factor (p-value = 0.000), blood pressure >= 90 mm Hg is a good predictor factor (p-value =0.001), speech difficulty is poor predictor factor (p-value = 0.004), outcome of inlet alone better than inlet and outlet. There are many factors affecting the surgical outcome in civilian penetrating head injury, and the significant factor is pre-operative GCS, CT-scan which is the best radiological investigation for pre-operative and post-operative assessment and show the details of the injury, blood pressure > = 90 mm Hg which is a good prognostic factor.

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Section: Resultssupporting

confidence: 67%

“…Eleven (31.4%) of the patients had a seizure, and 24 (68.6%) of them were free of seizure. Most of the studies showed a range of 25% -55% of seizure in post-PBI, and as a factor affecting the surgical outcome, it is not signi icant (Sights, 1969;Kim, 2001).…”

Section: Resultsmentioning

confidence: 99%

Factors affecting the outcome in surgically treated civilian penetrating head injury: Case series

Dolachee¹,

Lafta²,

Mohammed³

et al. 2019

ijrps

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“…This is represented by the equation ED = E/A (kinetic energy/cross-sectional area of the bullet), where kinetic energy equals (mass × velocity 2 )/2. Based on a previous study, the minimum ED of a BB to penetrate an adult skull is 7 × 10 4 ft•lbs/sq ft. 18 The most common caliber of a BB or pellet is 0.177, which equals a 0.177-inch diameter. BB and pellet weights range from 5.1 to 16.1 grains, where 437.5 grains equals 28.35 g. Using the lowest BB weight (5.1 grains or 0.33 g), adult skull penetration can occur at 1025.9 ft/sec.…”

Section: Discussionmentioning

confidence: 99%

Penetrating head injuries in children due to BB and pellet guns: a poorly recognized public health risk

Kumar

Mallory

et al. 2016

PED

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OBJECT Nonpowder guns, defined as spring- or gas-powered BB or pellet guns, can be dangerous weapons that are often marketed to children. In recent decades, advances in compressed-gas technology have led to a significant increase in the power and muzzle velocity of these weapons. The risk of intracranial injury in children due to nonpowder weapons is poorly documented. METHODS A retrospective review was conducted at 3 institutions studying children 16 years or younger who had intracranial injuries secondary to nonpowder guns. RESULTS The authors reviewed 14 cases of intracranial injury in children from 3 institutions. Eleven (79%) of the 14 children were injured by BB guns, while 3 (21%) were injured by pellet guns. In 10 (71%) children, the injury was accidental. There was 1 recognized assault, but there were no suicide attempts; in the remaining 3 patients, the intention was indeterminate. There were no mortalities among the patients in this series. Ten (71%) of the children required operative intervention, and 6 (43%) were left with permanent neurological injuries, including epilepsy, cognitive deficits, hydrocephalus, diplopia, visual field cut, and blindness. CONCLUSIONS Nonpowder guns are weapons with the ability to penetrate a child’s skull and brain. Awareness should be raised among parents, children, and policy makers as to the risk posed by these weapons.

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“…Civilian penetrating head injury is a leading cause of morbidity and mortality and represents a significant public health problem. The severity of the injury is related to several factors, including velocity of the bullet, refraction of a bullet after hitting a hard structure, distance of flight, caliber, and trajectory of passage through the cranium, expressiveness of the damaged brain, vascular injury and bullet migration [1][2][3]6,8,10,14,18,[20][21][22][23]25 . This last factor has been noted previously by other authors in the medical literature in the last 30 years.…”

Section: Introductionmentioning

confidence: 99%

Cranio-thoracic bullet migration over a period of 27 years: case report

Rangel¹,

Reyes-Soto²,

Mendizábal-Guerra³

2010

Neurocirugía

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SummaryWe report the case of a 36 year old woman that was hurt in the head with a lost bullet while walking through the street when she was 9 years old. On admission, the patient was fully conscious with no neurological deficits. Skull radiography showed the intracranial bullet but she was dispatched after 24 hours of observation without neurological deterioration. Six months later she suddenly presented quadriplegia and after one year of rehabilitation she recovered the mobility and strength in all her limbs. 25 years latter she began with thoracic pain (dermatomal sensory changes), constipation, paresthesias and weakness in the lower extremities; the X-Ray showed a bullet caliber 9 mm in the thoracic canal at T4 level. The bullet was removed via posterior laminectomy and dorsal midline mielotomy. 12 hours after surgery, the patient presented signs of medullar shock. The post-operatory MRI showed the trajectory of the bullet through the brain to the spinal cord in FLAIR, and spinal cord edema as well. The patient received steroids as treatment for the spinal cord edema, and with the help of rehabilitation she recovered movement in the lower extremities 30 days after the surgery.KEY WORDS: Thoracic canal. Quadriplegia. Laminectomy. Bullet. Migration. Migración craneo-torácica de una bala: descripción de un caso ResumenPresentamos el caso de una mujer de 36 años de edad, que resultó herida en la cabeza con una bala perdida mientras caminaba a través de la calle cuando tenía 9 años de edad. Ingresó en otro hospital consciente y sin déficit neurológico. La radiografía de cráneo mostró una bala intracraneal, pero se envió a su domicilio después de 24 horas de observación sin deterioro neurológico. Seis meses más tarde presentó quadriplejía de forma súbita. Después de un año de rehabilitación recuperó la movilidad y fuerza en sus miembros inferiores. Tras 25 años comenzó con dolor torácico (cambios sensoriales), estreñimiento, parestesias y debilidad en las extremidades inferiores; las radiografías simples de tórax mostraron una bala a nivel T4. La bala fue extirpada mediante laminectomía posterior y mielotomía dorsal de línea media. Doce horas después de la cirugía, el paciente presentó signos de shock medular. La resonancia magnética de cráneo mostró la trayectoria de la bala a través del cerebro a la médula espinal mediante FLAIR. Después de la operación la paciente continuó con esteroides y rehabilitación, recuperando la movilidad de los miembros inferiores, treinta días después de la cirugía.

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Ballistic Analysis of Shotgun Injuries to the Central Nervous System

Cited by 20 publications

References 8 publications

Factors affecting the outcome in surgically treated civilian penetrating head injury: Case series

Factors affecting the outcome in surgically treated civilian penetrating head injury: Case series

Penetrating head injuries in children due to BB and pellet guns: a poorly recognized public health risk

Cranio-thoracic bullet migration over a period of 27 years: case report

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