Prognosis for Gunshot Wounds to the Head

Ecklund, James M.; Sioutos, Panayiotis J.

doi:10.1016/j.wneu.2013.07.118

Cited by 4 publications

(8 citation statements)

References 25 publications

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“…In all studies, the GCS score was found to be the most important factor in determining the prognosis of the patient and the effectiveness of surgical treatment. [10,11,15,17,19,20,29] Pupillary changes, systemic shock, presence of infection, internal organ injuries and coagulation disorders increase the mortality of patients with higher GCS score. [24] Ventricular injuries, bihemispheric or midline injuries, large vessel injuries, and brain stem injuries increase the mortality of patients with CGW.…”

Section: Duraplasty 12mentioning

confidence: 99%

“…[24] Ventricular injuries, bihemispheric or midline injuries, large vessel injuries, and brain stem injuries increase the mortality of patients with CGW. [17,18,20,23,[29][30][31] Orbital and maxillofacial injuries may be associated with CGW and must be evaluated precisely by the surgeon to avoid further morbidities. [6,14,17,32] The major limitations of our study are the lack of long term follow-up period and the small number of the patient population.…”

Section: Duraplasty 12mentioning

confidence: 99%

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Prognostic Factors in Craniocerebral Gunshot Wounds: Analysis of 30 Patients from the Neurosurgical Viewpoint

Kirik

Yaşar

Durmaz

2020

Ulus Travma Acil Cerrahi Derg

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BACKGROUND: Craniocerebral gunshot wounds (CGW) are the most lethal injuries of the cranium. CGW is mostly secondary to military conflicts but may also be seen in civilian life. These injuries also have severe consequences, such as epilepsy, hydrocephalus, infection and late-term cognitive dysfunctions. The present study aims to present our series of CGW and to discuss the prognostic factors and consequences of these injuries. METHODS:The data of patients who were treated in our department for CGW between 2011 and 2019 were retrospectively reviewed in this study. The injury type, wounding site, surgical management and outcomes were analyzed. Radiological evaluation was also performed. RESULTS:Thirty patients were treated with the diagnosis of CGW. All of the patients were male and the mean age was 27.9 years. The frontal lobe was affected in 12 (40%) patients, while temporal lobe in eight, occipital lobe in six, parietal lobe in three, and posterior fossa in one patients. Twenty-three patients underwent surgical treatment, seven patients were treated conservatively. Thirteen (43.3%) patients died despite the treatment. CONCLUSION:Mortality in CGW is high. Ventricular injuries, bihemispheric or midline injuries, perforating injuries, brain stem injuries and low GCS score at admission are prognostic factors for CGW. Appropriate management is mandatory to obtain a better clinical outcome.

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Section: Duraplasty 12mentioning

confidence: 99%

Section: Duraplasty 12mentioning

confidence: 99%

Prognostic Factors in Craniocerebral Gunshot Wounds: Analysis of 30 Patients from the Neurosurgical Viewpoint

Kirik

Yaşar

Durmaz

2020

Ulus Travma Acil Cerrahi Derg

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“…The appearance of post-traumatic aneurysms in the internal maxillary artery has been reported in a range of weeks and months after the traumatic event, with the earliest time being 7 days later [5,7,9,[10][11][12][13][14][15]. Contrary to the majority of the case reports that can be reviewed in the literature, this patient with the appearance of a pseudoaneurysm in the maxillary artery almost immediately, which was diagnosed by performing a conventional angiography after a suspicion clinic by trauma mechanism and tomographic findings of high risk of vascular injury (Figure 4).…”

Section: Discussionmentioning

confidence: 99%

“…The clinical picture of this patient presented an indication for a neuroimaging evaluation; as indicated by the recommendations for head trauma of the NICE guidelines, which indicates the performance of an urgent image in the presence of focal neurological deficit; given in this patient by peripheral facial paralysis, the pupils of Marcus-Gunn that reflect damage in the optic nerve, and the injury in the abduction of the left eye [12][13][14]. Additionally, there are risk factors widely associated with the appearance of post-traumatic aneurysms at this level, such as projectile entry in the orbitopter area, the trajectory of the projectile is related to the great cerebral vessels, or in the presence of a subarachnoid hemorrhage or intracerebral hematoma.…”

Section: Discussionmentioning

confidence: 99%

Post-traumatic aneurysm of the early-onset internal maxillary artery

López¹,

Restrepo²,

Muñoz³

et al. 2019

Trauma Emerg Care

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Posttraumatic aneurysm (pseudoaneurysm) although are described extensively, occur infrequently in clinical practice, being them found with most frequently after surgical procedure such as osteotomies and TMJ surgery; this vascular disease also occurs regularly in wounds caused by projectile of firearm, and be originate weeks or months after the trauma. In the following case report of early onset pseudoaneurysm of the internal maxillary artery, which is quickly diagnosed by a high clinical suspicion of vascular injury and performing selective carotid angiography confirmed the diagnosis of pseudoaneurysm of almost immediate appearance. This patient is successfully treated with embolization coiling and had no complications after the procedure.

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“…As mentioned previously, one of the first challenges in managing patients with CGI is determining whether any intervention will result in an outcome that is acceptable to the patient, family, and society, 16) in this circumstance, the postresuscitation GCS is the most reliable and significant clinical predictor of outcome to date. 3 28 40 51 55) The series reported by Khan et al 36) confirmed the strong correlation between postresuscitation GCS score and outcome.…”

Section: Mortality and Prognosismentioning

confidence: 99%

Management of Craniocerebral Gunshot Injuries: A Review

Alvis-Miranda

Villafañe

Rojas

et al. 2015

Korean J Neurotrauma

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Craniocerebral gunshot injuries (CGI) are increasingly encountered by neurosurgeons in civilian and urban settings. Unfortunately this is a prevalent condition in developing countries, with major armed conflicts which is not very likely to achieve a high rate of prevention. Management goals should focus on early aggressive, vigorous resuscitation and correction of coagulopathy; those with stable vital signs undergo brain computed tomography scan. Neuroimaging is vital for surgical purposes, especially for determine type surgery, size and location of the approach, route of extraction of the foreign body; however not always surgical management is indicated, there is also the not uncommon decision to choose non-surgical management. The treatment consist of immediate life salvage, through control of persistent bleeding and cerebral decompression; prevention of infection, through extensive debridement of all contaminated, macerated or ischemic tissues; preservation of nervous tissue, through preventing meningocerebral scars; and restoration of anatomic structures through the hermetic seal of dura and scalp. There have been few recent studies involving penetrating craniocerebral injuries, and most studies have been restricted to small numbers of patients; classic studies in military and civil environment have identified that this is a highly lethal or devastating violent condition, able to leave marked consequences for the affected individual, the family and the health system itself. Various measures have been aimed to lower the incidence of CGI, especially in civilians. It is necessarily urgent to promote research in a neurocritical topic such as CGI, looking impact positively the quality of life for those who survive.

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Prognosis for Gunshot Wounds to the Head

Cited by 4 publications

References 25 publications

Prognostic Factors in Craniocerebral Gunshot Wounds: Analysis of 30 Patients from the Neurosurgical Viewpoint

Prognostic Factors in Craniocerebral Gunshot Wounds: Analysis of 30 Patients from the Neurosurgical Viewpoint

Post-traumatic aneurysm of the early-onset internal maxillary artery

Management of Craniocerebral Gunshot Injuries: A Review

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