Surgical Management of Penetrating Intracranial Bullet Injuries

This study aimed to determine the outcome after gunshot wounds (GSWs) to the head and to evaluate the impact of prognostic factors mentioned in the literature on the outcome. Methods: This prospective study included 30 patients; 24 males and 6 females with a mean age of 31 years. All with penetrating GSWs to the head admitted to the emergency department of Cairo University Hospitals from January 2008 till June 2011. Shotgun was the most common injury in this study, whereas bullet injury was in only 3 patients (10%). Preoperatively, patients were categorized according to their Glasgow Coma Scale (GCS) into mild, moderate, and severe penetrating head injury. Upon admission, all patients underwent a complete physical and neurological examination together with a computed tomography of the brain without contrast. Initial management included a variety of the following according to indications; resuscitation, prophylactic antiepileptics, antibiotics, control active bleeding from wounds, and measures to decrease intracranial pressure. Surgical intervention ranged from simple debridement to hematoma evacuation and/or bullet extraction. Outcome was assessed after surgical interference using GCS and Glasgow Outcome Scale. Results: Fifteen (50%) patients had mild penetrating head injury (GCS 13 to 15), 12 patients (40%) were severely injured (GCS 3 to 8), and only 3 patients (10%) were moderately injured (GCS 9 to 12). Eighteen patients (60%) were found to have isolated intracranial in...
Source: Neurosurgery Quarterly - Category: Neurosurgery Tags: Original Articles Source Type: research