Successful surgical treatment of a patient with combined gunshot shrapnel injuries in the heart and brain complicated by middle cerebral artery pseudoaneurysm

Sirko, Andriy; Kyrpa, Ihor; Лазоришинець, В. В.; Zorin, Mykola; Cherednychenko, Yu.V.; Plyushchev, Illya; Romanukha, Dmytro

doi:10.1016/j.tcr.2018.11.001

Cited by 4 publications

(2 citation statements)

References 15 publications

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“…Imaging modalities such as echocardiography can play a crucial role in the dynamic monitoring of cardiac foreign bodies and the detection of associated complications [ 5 ]. The mortality rate can vary depending on factors such as the type and severity of the injury, the presence of associated injuries, and the timeliness of intervention [ 8 ]. This case report contributes to the current literature when any patient has a penetrating injury in the cardiac box and is highly suspect of a cardiac injury, regardless of the material of the injury.…”

Section: Discussionmentioning

confidence: 99%

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Management of an accidental penetrating cardiac injury in a 4-year-old girl

Ali,

Kapan,

Siyad

et al. 2023

International Journal of Surgery Case Reports

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Section: Discussionmentioning

confidence: 99%

“…These injuries can result from both blunt and penetrating trauma, such as stab wounds, gunshot wounds, or foreign body penetration [ 4 , 5 , 6 ]. The prognosis for penetrating cardiac injuries is generally poor, with high mortality rates reported in the literature [ 7 , 8 ].…”

Section: Introductionmentioning

confidence: 99%

Management of an accidental penetrating cardiac injury in a 4-year-old girl

Ali,

Kapan,

Siyad

et al. 2023

International Journal of Surgery Case Reports

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Successful Surgical Treatment of Severe Perforating Diametric Craniocerebral Gunshot Wound Sustained during Combat: A Case Report

et al. 2019

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Many researchers classify perforating diametric craniocerebral gunshot wounds as fatal because mortality exceeds 96% and the majority of patients with such injuries die before hospitalization. A 23-year-old Ukrainian male soldier was admitted to a regional hospital with a severe perforating craniocerebral wound in a comatose state (Glasgow Coma Scale score, 5). Following brain helical computed tomography, the patient underwent primary treatment of the cerebral wound with primary duraplasty and inflow/outflow drainage. After 18 days of treatment in the intensive care unit, he was transferred to a military hospital for further rehabilitation. This report details our unusual case of successful treatment of a perforating diametric craniocerebral gunshot wound.

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Mortality and Functional Outcome Predictors in Combat-Related Penetrating Brain Injury Treatment in a Specialty Civilian Medical Facility

et al. 2020

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Introduction The combined use of new types of weapons and new types of personal protective equipment has led to changes in the occurrence, nature, and severity of penetrating brain wounds. The availability of modern equipment, methods of treatment, and trained medical personnel in a civilian hospital, as well as advanced specialty medical care, has improved treatment outcomes. There have been a limited number of publications regarding analysis and predictors of treatment outcomes in patients with combat-related penetrating brain injury in contemporary armed conflicts. The purpose of this study was to analyze the results of surgical treatment of patients with penetrating brain injury and to identify significant outcome predictors in these patients. Materials and Methods This was a prospective analysis of penetrating brain injury in patients who were admitted to Mechnikov Dnipropetrovsk Regional Clinical Hospital, Ukraine, from May 9, 2014, to December 31, 2017. All wounds were sustained during local armed conflict in Eastern Ukraine. The primary outcomes of interest were mortality rate at 1 month and Glasgow Outcome Scale score at 12 months after the injury. Results In total, 184 patients were identified with combat-related brain injury; of those, 121 patients with penetrating brain injury were included in our study. All patients were male soldiers with a mean age of 34.1 years (standard deviation [SD], 9.1 years). Mean admission Glasgow Coma Scale score was 10 (SD, 4), and mean admission Injury Severity Score was 27.7 (SD, 7.6). Mortality within 1 month was 20.7%, and intracranial purulent-septic complications were diagnosed in 11.6% of the patients. Overall, 65.3% of the patients had favorable outcome (good recovery or moderate disability) based on Glasgow Outcome Scale score at 12 months after the injury. The following were predictors of mortality or poor functional outcome at 1 year after the injury: low Glasgow Coma Scale score on admission, gunshot wound to the head, dural venous sinuses wound, presence of intracerebral hematomas, intraventricular and subarachnoid hemorrhage accompanied by lateral or axial dislocation, and presence of intracranial purulent-septic complications. Conclusions Generally, combat-related penetrating brain injuries had satisfactory treatment outcomes. Treatment outcomes in this study were comparable to those previously reported by other authors in military populations and significantly better than outcomes of peacetime penetrating brain injury treatment.

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Successful surgical treatment of a patient with combined gunshot shrapnel injuries in the heart and brain complicated by middle cerebral artery pseudoaneurysm

Cited by 4 publications

References 15 publications

Management of an accidental penetrating cardiac injury in a 4-year-old girl

Management of an accidental penetrating cardiac injury in a 4-year-old girl

Successful Surgical Treatment of Severe Perforating Diametric Craniocerebral Gunshot Wound Sustained during Combat: A Case Report

Mortality and Functional Outcome Predictors in Combat-Related Penetrating Brain Injury Treatment in a Specialty Civilian Medical Facility

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