Surgical therapy for craniocerebral firearm injury

Abstract

AIm:The current study aims to explore the clinical characteristics of craniocerebral firearm injury and to improve the diagnosis and treatment of this condition. mAterIAl and methOds: Data from 56 patients with craniocerebral firearm injury were analyzed retrospectively for projectile types, traumatic conditions, and treatment approaches.results: 43 patients exhibited intracranial foreign body residence. Of them, 40 were subjected to complete foreign body removal and 2 to partial removal, leaving 1 without receiving removal treatment. 54 patients (96.4%) survived and 2 (3.6%) died. Of the survivors, 36 (64.3%) recovered well, 15 (26.8%) were moderately disabled, 2 (3.6%) were severely disabled, and 1 (1.8%) lapsed into vegetative state. Patients receiving debridement within 8 h after injury had a significantly higher recovery rate than those receiving such treatment after 8 h (82.1% vs. 26.7%; P < 0.001).COnClusIOn: Craniocerebral firearm injury is characterized by rapid traumatic condition development as well as serious trauma and contamination. Accurately judging the traumatic condition and the ballistic tract, performing complete debridement as early as possible, reasonably deciding on the operative mode and approach for intracranial residing foreign body removal, and increasing vigilance regarding concomitant injuries are the keys to the improvement of the overall treatment of craniocerebral firearm injury. KeywOrds: Craniocerebral injury, Firearm injury, Surgery ÖZAmAÇ: Mevcut çalışma kraniyoserebral ateşli silah yaralanmasının klinik özelliklerini incelemeyi ve böyle bir durumun tanı ve tedavisini geliştirmeyi amaçlamaktadır. yÖntem ve GereÇler: Kraniyoserebral ateşli silah yaralanması olan 56 hastanın verileri projektil tipleri, travmatik durumlar ve tedavi yaklaşımları açısından retrospektif olarak incelendi.BulGulAr: 43 hastada intrakraniyal yabancı cisim vardı. Bunlar içinde 40'ında yabancı cisim tamamen çıkarılırken 2'sinde kısmen çıkarıldı ve 1 hastada çıkarma için işlem yapılmadı. 54 hasta (%96,4) yaşadı ve 2 hasta (%3,6) öldü. Yaşayanlar içinde 36'sı (%64,3) iyi iyileşti, 15'i (%26,8) orta derecede engelli kaldı, 2'si (%3,6) şiddetli engelli kaldı ve 1'i (%1,8) vejetatif duruma girdi. Yaralanmadan sonraki 8 saat içinde debridman yapılan hastalarda iyileşme oranı bu tedavinin 8 saatten sonra yapıldığı hastalara göre çok daha iyiydi (%82,1 vs. %26,7; P < 0.001).sOnuÇ: Kraniyoserebral ateşli silah yaralanması hızlı travmatik durum gelişmesi ve ayrıca ciddi travma ve kontaminasyonla ilişkilidir. Travmatik durumu ve balistik yolu doğru olarak belirlemek, mümkün olduğunca erken dönemde tam debridman yapmak, operatif mod ve intrakraniyal kalmış yabancı cismin çıkarılmasına yaklaşıma makul bir şekilde karar vermek ve eş zamanlı yaralanmalar açısından dikkatli olmak kraniyoserebral ateşli silah yaralanmalarında genel tedavi düzeyini arttırmanın temelleridir.AnAhtAr sÖZCÜKler: Kraniyoserebral yaralanma, Ateşli silah yaralanması, Cerrahi

Right-to-Left Displacement of an Airgun Lead Bullet after Transorbital Entry into the Skull Complicated by Posttraumatic Epilepsy : A Case Report

“…Some scholars believe that the metallic foreign bodies can’t to remove when they are located in deep vital structures, with small in size or has life-threatening by operation. However, for lead bullets and cranial fragment bodies, they should be removed completely because of their increased toxicity and chance of infection compared with other foreign bodies [ 23 ]. In addition, intracranial shrapnel or projectiles >5 mm in diameter need to be completely removed because they are prone to foreign body displacement and can cause local brain tissue hyperplasia inducing epilepsy or toxic effects on brain tissue (especially lead and aluminum bullets) [ 12 ].…”

Factors associated with hospital outcomes of patients with penetrating craniocerebral injuries in armed conflict areas of the Democratic Republic of the Congo: a retrospective series

“…On the other hand, Paradot et al [7], Aarabi et al [5], and Wei et al [16] found respectively that the age (< 15 years vs > 16 years) of patients, the time between injury and admission (< 8 h vs > 8 h) were differently distributed in terms of outcomes. This may be explained by the difference of distribution of age and time from injury to the hospital between our study and theirs [5,16]. Literature has documented that patients victims of PCCI had most of the time a low GCS and unstable hemodynamic state [4,17,18].…”