Comparison of clinical outcomes between anteroposterior and lateral penetrating craniocerebral gunshot wounds

Abstract

Objective: To investigate and compare, using a retrospective clinical study, the clinical outcomes of penetrating craniocerebral gunshot wounds (PCGW) with respect to the trajectory of penetration in the axial plane. Methods: In total, 22 patients with PCGW caused by conflict, suicide attempt, or accidental firing were included in this study. They were divided into two groups: anteroposterior and lateral. All patients underwent surgical treatment following emergency intervention. Results: Of the 22 patients, 16 had anteroposterior and 6 had lateral penetrating injury. Four patients with anteroposterior and five patients with lateral injury died despite surgical treatment. Mortality rate was 25% in the anteroposterior and 83% in the lateral injury group. Conclusion: We found that lateral PCGW is the most devastating type of missile injury to the head.

Cranial and spinal cord injuries in Terror and War

“…Birinci Dünya Savaşı'nda Harvey Cushing kraniyal ateşli silah yaralanmalarının tedavisinde öncü-lük yapmış, yüksek ölüm oranlarının önlenebileceği-ni savunmuştur (12) . Cushing'e göre kraniyal ASY'nin tedavisinde antibiyotik ve elektrokoagülasyon öncesi ve sonrası olmak üzere iki dönem vardır (12)(13)(14) . Antibiyoterapi ve ameliyatlarda elektrokoagülasyon kullanımı ile ölüm oranları %78'lerden %28,8'lere kadar düşmüştür.…”

“…Antibiyoterapi ve ameliyatlarda elektrokoagülasyon kullanımı ile ölüm oranları %78'lerden %28,8'lere kadar düşmüştür. Cushing, kraniyal ASY'yi şiddetine göre sınıflandırmış, farklı cerrahi teknikler ortaya koymuş ve bu konuda nöroşirürjiyenleri eğitmiştir (14) . Birinci Dünya Savaşında kraniyal ASY'de kraniotomi, debritman ve kapatma klasik bir cerrahi teknik iken, İkinci Dünya Savaşında Cairns bu cerrahi tekniklere ek olarak osteoplastik kraniotomiyi uygulamıştır (15) .…”

“…Orbita da kraniyal ASY'den etkilenebilir (17) . Ventriküler bölge ve beyin sapı yaralanmaları prognoz açısından en kötü olanlarıdır (14,16) . Tedavi genellikle yaralanma yeri ve bü-yüklüğüne göre planlanmakta ve prognoz buna göre belirlenmektedir (12,14) .…”

The evolution of military neurosurgery in the Turkish army

“…Craniocerebral trauma is still common during military conflicts. 3,4,6,7,16 Today, with advances in head armor, resuscitation in the battlefield, rapid evacuation, and surgical treatment in the operating theater, patients with traumatic brain injuries have an increased chance of survival, but the majority of patients suffer a penetrating head injury from an explosive blast. Now, landmine explosions cause most of the injuries in terrorist actions and also pose a public health risk.…”

“…Now, landmine explosions cause most of the injuries in terrorist actions and also pose a public health risk. 6,7,15 Additionally, warfare also causes a large number of peripheral nerve injuries. 1,13,14 Despite the considerable progress in diagnosis and treatment of peripheral nerve injuries, morbidity after such injuries is still unacceptably high.…”