Pediatric gunshot wounds to the head and neck☆☆☆★

Abstract

Gunshot wounds to the head and neck in the pediatric population have become alarmingly common. They often result in death of the victim, devastate families, and inflict a considerable financial burden to hospitals and society. We present a retrospective study of cases treated at a level I trauma center in Houston, Texas, from July 1990 to July 1993. We identified 115 cases of gunshot wounds in children, 32 of which were exclusively confined to the head and neck region. There were 26 male and 6 female patients. Ages ranged from 3 to 17 years. The cranial cavity was involved in 13 cases, leading to 9 deaths and 1 institutionalization. The shootings took place at home in 11 cases, and they involved play in 12 cases. The shooter was known to 14 of the victims, and the wounds were self-inflicted in 7 cases. The most common type of weapon was the .22 caliber pistol, which caused four of the deaths. Two of our cases involved BB air rifles, one of which mandated a craniotomy for the evacuation of an epidural hematoma. Our findings indicate that gunshot wounds to head and neck in children are in most instances preventable and result in high fatality rates because of common intracranial involvement, even when low-energy missiles are used.

Relationships of Alpha-SMA-Positive Fibroblasts and SDF-1-Positive Tumor Cells with Neoangiogenesis in Nasopharyngeal Carcinoma

“…In the present study, high microvessel density was obtained in NPC stroma and putative EPCs were observed near microvessels, suggesting the tumor-associated neoangiogenesis in NPC. Since concomitant chemoradiotherapy (i.e., cisplatin and 5-fluorouracil followed by radiation) is currently recommended for invasive NPC [ 44 ], antiangiogenic therapy in combination with cytotoxic therapies [ 45 ] would help to improve general treatment approaches for NPC. Our present study provides the possibility of targeting angiogenesis-related molecules and CAFs for treating NPC.…”

Craniofacial Anthropometry of Healthy Turkish Young Adults: Analysis of Head and Face

“…Standardization has been achieved with FHP in many studies using craniofacial anthropometric measurements 13–16 . In profile view, FHP is the line that runs from the uppermost point of the opening of the external auditory canal to the lowest point on the infraorbital margin 17 . Natural head position is the standardized and easily repeatable position of the head obtained when the subject looks at a point in the distance at eye level.…”

“…[13][14][15][16] In profile view, FHP is the line that runs from the uppermost point of the opening of the external auditory canal to the lowest point on the infraorbital margin. 17 Natural head position is the standardized and easily repeatable position of the head obtained when the subject looks at a point in the distance at eye level. The simplest way to achieve NHP is to have to subject look at a point in line with their eyes on the opposite wall.…”

Penetrating Neck Trauma in Children: An Urban Hospital's Experience

“…Injuries by firearms have reached epidemic proportions, causing the loss of thousands of lives and a financial burden to the health care system. 5 Firearm injuries are the second leading cause of death for young people aged 10 to 24 years. As of 1994, 29% of those who died of firearm injuries were 15 to 24 years old.…”