Head trauma by captive bolt gun

Oikonomou, Anastasia; Astrinakis, Manos; Birbilis, Theodossios; Pavlidis, Pavlos; Prassopoulos, Panos

doi:10.1136/bcr.09.2011.4809

Cited by 2 publications

(9 citation statements)

References 6 publications

(3 reference statements)

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“…( C,D ) Captive bolt pistol injury. Note the pathognomic finding with a wide hemorrhagic wound canal and corresponding bone fragment at the end of the canal with the absence of metallic fragments or exit sites ( 19 – 21 ).…”

Section: Resultsmentioning

confidence: 99%

“…Interestingly, CBP was used in 21% of our patient cohort, while in general CBP is seen as a very rare type of PBI. Only a few reports on CBP injuries exist, which exclusively come from European countries, where this animal slaughter technique is widely used and licence policy for these tools is generally less strict ( 19 – 21 ). In our series, CBP injuries were exclusively used in self-inflicted injuries and showed typical findings on CCT with a displaced skull fragment into the parenchyma ( Figures 1C,D ).…”

Section: Discussionmentioning

confidence: 99%

“…In our series, CBP injuries were exclusively used in self-inflicted injuries and showed typical findings on CCT with a displaced skull fragment into the parenchyma ( Figures 1C,D ). A mortality of 60%–90% has been reported in the literature ( 19 , 20 ). This is in strong contrast to our series with no mortality during the follow-up and a favourable outcome in 40% of patients.…”

Section: Discussionmentioning

confidence: 99%

“…Captive bolt pistol (CBP) injuries represent a rare type of PBI. This device is used in animal slaughter, where a bolt is propelled through the skull into the brain with an average velocity of about –75 m/s and is then retracted by a spring ( 19 ). In contrast to popular belief, the purpose of most CBP is not to kill the animal but to stun it prior to slaughter by inducing unconsciousness.…”

Section: Introductionmentioning

confidence: 99%

“…In contrast to popular belief, the purpose of most CBP is not to kill the animal but to stun it prior to slaughter by inducing unconsciousness. Only a few reports exist in the literature about its misuse in a suicidal or homicidal manner, which mostly comes from European countries where this slaughter technique is frequently used ( 19 ). Considering the nature of this injury, CBP injuries should be categorized as LVI.…”

Section: Introductionmentioning

confidence: 99%

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Surviving the Scene in Civilian Penetrating Brain Injury: Injury Type, Cause and Outcome in a Consecutive Patient Series in Austria

et al. 2022

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BackgroundPenetrating brain injury (PBI) is a heterogeneous condition with many variables. Few data exist on civilian PBI. In some publications, PBI differentiation between low-velocity injury (LVI) and high-velocity injury (HVI) is made, but exact definitions are not given yet. The incidence of PBI depends heavily on the country of origin. Furthermore, captive bolt pistol (CBP) injuries represent a rare type of LVI and almost no reports exist in the human medical literature. Treatment of PBI has been controversially discussed due to high morbidity and mortality with results varying considerably between series. Prognostic factors are of utmost importance to identify patients who presumably benefit from treatment.MethodsA retrospective, single-center analysis of a consecutive patient series was performed from September 2005 to May 2018. We included all patients with PBI who reached our hospital alive and received any neurosurgical operative procedure.ResultsOf 24 patients, 38% died, 17% had an unfavourable outcome, and 46% had a favourable outcome. In total, 58% of patients with PBI were self-inflicted. Leading causes of injury were firearms, while captive bolt pistols were responsible for 21% of injuries. LVI represented 54%, and HVI represented 46%. The outcome in HVI was significantly worse than that in LVI. A favourable outcome was achieved in 69% of LVI and 18% of HVI. Low GCS and pathological pupillary status at admission correlated significantly with an unfavourable outcome and death.ConclusionsPBI is a heterogeneous injury with many variables and major geographical and etiological differences. Differentiation between LVI and HVI is crucial for decision-making and predicting outcomes. In patients presenting with object trajectories crossing the midline, no favourable outcome could be achieved. Nevertheless, in total, a favourable outcome was possible in almost half of the patients who succeeded in surgery.

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Section: Resultsmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Surviving the Scene in Civilian Penetrating Brain Injury: Injury Type, Cause and Outcome in a Consecutive Patient Series in Austria

et al. 2022

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Captive Bolt Gun-Related Vascular Injury: A Single Center Experience

Pešak,

Porčnik,

Prestor

2024

Diagnostics

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This article investigates the clinical and radiological characteristics of captive bolt gun head injuries, a rare form of low-velocity penetrating brain injury. Eleven consecutive patients were included in the study. Vascular injuries and the rate of infection were systematically analyzed. Radiological findings reveal common bolt trajectories in the anterior cranial fossa, with identified risk factors for a poor outcome including trajectory crossing midline, hematocephalus, and paranasal sinus involvement. Only one patient had a good outcome. Despite meticulous microsurgical techniques, this study highlights often unfavorable clinical outcomes in captive bolt gun injuries, with vascular injury identified as a potential contributing risk factor for a poor outcome. Knowledge of variant vascular tree anatomy and corresponding vascular territory is important. To avoid potential vascular injuries, a complete removal of bone fragments was not always performed and it did not increase the rate of infection, challenging the conventional wisdom advocating for the complete removal of bone fragments. These findings contribute novel insights into captive bolt gun-related injuries, paving the way for further research.

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Head trauma by captive bolt gun

Cited by 2 publications

References 6 publications

Surviving the Scene in Civilian Penetrating Brain Injury: Injury Type, Cause and Outcome in a Consecutive Patient Series in Austria

Surviving the Scene in Civilian Penetrating Brain Injury: Injury Type, Cause and Outcome in a Consecutive Patient Series in Austria

Captive Bolt Gun-Related Vascular Injury: A Single Center Experience

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