BACKGROUND: Civilian gunshot injuries to the brain are relatively rare and study of these injuries has been neglected in South Korea. METHODS: Thirteen patients with civilian craniocerebral gunshot injuries were admitted to the Chonnam National University Hospital during a period of 22 years. A retrospective analysis of these patients with regard to outcome and prognostic factors was performed. RESULTS: The Glasgow Coma Scale (GCS) score at admission was recorded to be 3 to 5 in one patient, 6 to 8 in three patients, 9 to 12 in two patients, and 13 to 15 in seven patients. The admission GCS score was the most valuable prognostic factor. Of the nine patients with a GCS score of more than 8, eight patients survived with favorable outcomes; of the four patients with a GCS score of less than 8, all had unfavorable outcomes (1 died, and 3 had severe disability). There was a correlation between the presence of a transventricular or bihemispheric trajectory and poor outcome. CONCLUSIONS: Patients with GCS scores of more than 8 or brain lesions limited to a single lobe of the brain can benefit from early aggressive management. Our results suggest that retained fragments after first debridement did not increase the risk of infection or seizure.
BACKGROUND: Civilian gunshot injuries to the brain are relatively rare and study of these injuries has been neglected in South Korea. METHODS: Thirteen patients with civilian craniocerebral gunshot injuries were admitted to the Chonnam National University Hospital during a period of 22 years. A retrospective analysis of these patients with regard to outcome and prognostic factors was performed. RESULTS: The Glasgow Coma Scale (GCS) score at admission was recorded to be 3 to 5 in one patient, 6 to 8 in three patients, 9 to 12 in two patients, and 13 to 15 in seven patients. The admission GCS score was the most valuable prognostic factor. Of the nine patients with a GCS score of more than 8, eight patients survived with favorable outcomes; of the four patients with a GCS score of less than 8, all had unfavorable outcomes (1 died, and 3 had severe disability). There was a correlation between the presence of a transventricular or bihemispheric trajectory and poor outcome. CONCLUSIONS:Patients with GCS scores of more than 8 or brain lesions limited to a single lobe of the brain can benefit from early aggressive management. Our results suggest that retained fragments after first debridement did not increase the risk of infection or seizure.
Authors: Hernando Raphael Alvis-Miranda; Andres M Rubiano; Amit Agrawal; Alejandro Rojas; Luis Rafael Moscote-Salazar; Guru Dutta Satyarthee; Willem Guillermo Calderon-Miranda; Nidia Escobar Hernandez; Nasly Zabaleta-Churio Journal: Bull Emerg Trauma Date: 2016-04
Authors: Hernando Raphael Alvis-Miranda; Roberto Adie Villafañe; Alejandro Rojas; Gabriel Alcala-Cerra; Luis Rafael Moscote-Salazar Journal: Korean J Neurotrauma Date: 2015-10-31