Civilian Gunshot Wounds to the Head: A Prospective Study

Grahm, Thomas W.; Williams, Fred C.; Harrington, Timothy; Spetzler, Robert F.

doi:10.1227/00006123-199011000-00005

Cited by 167 publications

(112 citation statements)

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“…Penetrating head injuries are seen in males more in the literature searches (2,4,5,8,11,14). In our study, such injuries were also determined higher in males in comparison to females (males: 80% and females: 20%).…”

Section: Discussionsupporting

confidence: 63%

One year experience of emergency service in patients with penetrating head trauma due to firearm

et al. 2016

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Section: Discussionsupporting

confidence: 63%

One year experience of emergency service in patients with penetrating head trauma due to firearm

et al. 2016

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“…However, low GCS scores at admission are generally considered to be related to higher mortality. 4,16,42) In our series, this relationship was statistically significant (p º 0.05).…”

Section: Discussionsupporting

confidence: 53%

“…4,12,16,20,29,37,39) The high mortality in these lesions could be associated with pathophysiological mechanisms. This type of a lesion has greater potential to destroy crucial vascular structures because of the anatomical position and relatively long trajectory.…”

Section: Discussionmentioning

confidence: 99%

“…17,18) The mortality ranges from 23% to 92% and is markedly higher at 87-100% in patients admitted with poor neurological status. 3,4,8,11,13,16,19,22,23,25,29,34,35,37,39) Many other factors have been associated with mortality including hemodynamic and respiratory status at admission, missile type, pupil diameter and reactivity, and computed tomography (CT) findings. 7,12,19,20,22,28,34,41) Surgical intervention must be performed as soon as possible, if indicated.…”

Section: Introductionmentioning

confidence: 99%

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High-Velocity Gunshot Wounds to the Head: Analysis of 135 Patients

Bakir

Temız

Umur

et al. 2005

Neurol. Med. Chir.(Tokyo)

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Head injuries due to high-velocity missiles and shrapnel as a result of military conflicts have become a very important cause of death or severe neurological deficits. Military-type missiles have high velocities and transfer higher amounts of energy to neural tissue, compared to civil-type missiles. This physical phenomenon also causes greater neural tissue destruction. Shrapnel particles derive from blasts and cause less severe injury because of the irregular particle shape and low energy transmission. This study analyzed 135 patients with head trauma, 80 patients (59%) injured by missiles and 55 patients (41%) by shrapnel. Glasgow Coma Scale (GCS) scores at admission were 3 to 7 in 69 patients, 8 to 10 in 29 patients, and 11 to 15 in 37 patients. The most common anatomical localizations were the right frontoparietal region in 42 patients and the left frontoparietal region in 40 patients. One hundred patients (74%) were operated on immediately and 35 patients (26%) were treated conservatively in the intensive care unit. Ten of the 135 patients died (7.4%), seven from missile injury and three from shrapnel injury. In this study, we found that high mortality was associated with low GCS score at admission, presence of multilobar or skull base injuries, and involvement of ventricles. Early and aggressive surgical intervention decreased the mortality.

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“…Two million people suffer traumatic brain injury in the United States annually, and brain trauma is the leading cause of death and disability among young adults (Grahm et al, 1990;Harrison and Dijkers, 1992;LeRoux and Grady, 1995). Of head trauma survivors, 10 -15% develop post-traumatic epilepsy, and after penetrating injuries this number rises to 53% (Salazar et al, 1985;Salazar, 1992).…”

Section: Implications For Post-traumatic Epilepsymentioning

confidence: 99%

Instantaneous Perturbation of Dentate Interneuronal Networks by a Pressure Wave-Transient Delivered to the Neocortex

et al. 1997

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Whole-cell patch-clamp recordings and immunocytochemical experiments were performed to determine the short-and longterm effects of lateral fluid percussion head injury on the perisomatic inhibitory control of dentate granule cells in the adult rat, with special reference to the development of traumainduced hyperexcitability. One week after the delivery of a single, moderate (2.0-2.2 atm) mechanical pressure wave to the neocortex, the feed-forward inhibitory control of dentate granule cell discharges was compromised, and the frequency of miniature IPSCs was decreased. Consistent with the electrophysiological data, the number of hilar parvalbumin (PV)-and cholecystokinin (CCK)-positive dentate interneurons supplying the inhibitory innervation of the perisomatic region of granule cells was decreased weeks and months after head injury. The initial injury to the hilar neurons took place instantaneously after the impact and did not require the recruitment of active physiological processes. Furthermore, the decrease in the number of PV-and CCK-positive hilar interneurons was similar to the decrease in the number of the AMPA-type glutamate receptor subunit 2/3-immunoreactive mossy cells, indicating that the pressure wave-transient causes injurious physical stretching and bending of most cells that are large and not tightly packed in a cell layer.These results reveal for the first time that moderate pressure wave-transients, triggered by traumatic head injury episodes, impact the dentate neuronal network in a unique temporal and spatial pattern, resulting in a net decrease in the perisomatic control of granule cell discharges.

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Civilian Gunshot Wounds to the Head: A Prospective Study

Cited by 167 publications

References 0 publications

One year experience of emergency service in patients with penetrating head trauma due to firearm

One year experience of emergency service in patients with penetrating head trauma due to firearm

High-Velocity Gunshot Wounds to the Head: Analysis of 135 Patients

Instantaneous Perturbation of Dentate Interneuronal Networks by a Pressure Wave-Transient Delivered to the Neocortex

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