Similarities between Civilian Gunshot Wounds to the Head and Nongunshot Head Injuries

Valadka, Alex B.; Gopinath, Shankar P.; Mizutani, Yasufumi; Chacko, Ari G; Robertson, Claudia S.

doi:10.1097/00005373-200002000-00017

Cited by 17 publications

(6 citation statements)

References 26 publications

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“…In addition, a penetrating mechanism of injury was more likely to be associated with GCS 8. Similar results were obtained by Valadka et al[69] in a study of patients admitted to the ICU with gunshot and non-gunshot TBIs. A rapid progression to death occurred in 71% of the patients with gunshot TBIs, in comparison to 17% of the patients with non-gunshot TBIs; thus confirming the higher lethality of gunshot wounds over other mechanisms of injury.…”

supporting

confidence: 89%

“…This drawback is quite evident from civilian studies where investigators either fail to classify TBIs by mechanism of injury or exclude penetrating injuries from the final outcome analysis. An exception to this analytical approach is notable in a study by Valadka et al [69] from Houston. Data from 63 gunshot- Harrison-Felix et al [79].…”

Section: Functional Outcomesmentioning

confidence: 99%

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Characterization and Application of a Large Animal Model of Penetrating Ballistic Brain Injury (PBBI)

Wade¹

2012

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supporting

confidence: 89%

Section: Functional Outcomesmentioning

confidence: 99%

Characterization and Application of a Large Animal Model of Penetrating Ballistic Brain Injury (PBBI)

Wade¹

2012

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“…According to Valadka et al, who compared the outcome of GSWB with similar brain injuries caused by other mechanisms, salvageable GSWB patients can make a similar recovery to brain injury patients with similar injuries from other mechanisms [ 35 ]. However, GSWB leads to higher ICP and lower CPP than other mechanisms of brain injury [ 35 ], which suggests that salvageable GSWB patients would especially need neurointensive monitoring and care.…”

Section: Discussionmentioning

confidence: 99%

Outcome and rational management of civilian gunshot injuries to the brain—retrospective analysis of patients treated at the Helsinki University Hospital from 2000 to 2012

et al. 2019

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Background Treatment of gunshot wounds of the brain (GSWB) remains controversial and there is high variation in reported survival rates (from < 10 to > 90%) depending on the etiology and country. We retrospectively analyzed the outcome of a series of consecutive GSWB patients admitted alive to a level 1 trauma center in a safe high-income welfare country with a low rate of homicidal gun violence. Methods Patients admitted due to a GSWB to the HUS Helsinki University Hospital during 2000–2012 were identified from hospital discharge registry and log books of the emergency room and ICU. CT scans and medical records of these patients were reviewed. Univariate analysis and backward logistic regression were performed, and their results compared with that of a systematic literature review of factors related to the outcome of GSWB patients. Results Sixty-four patients admitted alive after GSWB were identified. Eighty percent had self-inflicted GSWB, 81% were contact shots, and 70% were caused by handguns. In-hospital mortality was 72%. Factors associated with mortality in our series were low GCS (≤ 8) at admission, transventricular bullet trajectory, and associated damage to deep brain structures, as reported before in the literature. Of the 64 patients admitted alive, 42% (27/64) were admitted to ICU, 34% (22/64) underwent surgery, and in 25% (16/64), craniotomy and hematoma evacuation was performed. Mortality in the surgically treated group was 32% but near 100% without surgery and ICU treatment. Median GOS in the surgically treated patients was 3 (range 1–5). Conclusions GSWB caused by contact shot from handguns has a high mortality rate, but can be survived with reasonable outcome if limited to lobar injury without significant damage to deep brain structures or brain stem. In such GSWB patients, initial aggressive resuscitation, ICU admission, and surgery seem indicated. Electronic supplementary material The online version of this article (10.1007/s00701-019-03952-y) contains supplementary material, which is available to authorized users.

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“…Most of the gunshot wounds to the head studies have been focused on demographics, outcome, histological, forensic and anatomical findings, or complications like infections, seizures, vascular injuries and psychological effects (5).…”

Section: Discussionmentioning

confidence: 99%

Oyun parkında ateşli silah yaralaması: Olgu sunumu

Gurcan¹

2009

jaem

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Similarities between Civilian Gunshot Wounds to the Head and Nongunshot Head Injuries

Cited by 17 publications

References 26 publications

Characterization and Application of a Large Animal Model of Penetrating Ballistic Brain Injury (PBBI)

Characterization and Application of a Large Animal Model of Penetrating Ballistic Brain Injury (PBBI)

Outcome and rational management of civilian gunshot injuries to the brain—retrospective analysis of patients treated at the Helsinki University Hospital from 2000 to 2012

Oyun parkında ateşli silah yaralaması: Olgu sunumu

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