Minim Invasive Neurosurg 2005; 48(2): 113-118
DOI: 10.1055/s-2004-830222
Original Article
© Georg Thieme Verlag Stuttgart · New York

Craniocerebral Gunshot Wounds: Results of Less Aggressive Surgery and Complications

A.  Coşar1 , E.  Gönül2 , E.  Kurt1 , M.  Gönül3 , M.  Taşar4 , S.  Yetişer5
  • 1Department of Anaesthesiology, GATA Medical School, Etlik-Ankara, Turkey
  • 2Department of Neurosurgery, GATA Medical School, Etlik-Ankara, Turkey
  • 3Department of Dermatology, Ministry of Health Ankara, Numune Education and Research Hospital, Ankara, Turkey
  • 4Department Radiology, GATA Medical School, Etlik-Ankara, Turkey
  • 5Department of Oto-Rhino-Laryngology and Head and Neck Surgery, GATA Medical School, Etlik-Ankara, Turkey
Further Information

Publication History

Publication Date:
19 May 2005 (online)

Abstract

Four hundreds patients who suffered from cranial gunshot wounds injuries were analyzed. Surgical therapy, primary and secondary debridement, including repair of dural defects and removal of retained intracranial bone and metal fragments were applied. Central nervous system infections were mostly observed in cases with cerebrospinal fluid (CSF) fistulas. In 130 of 400 patients, bone and metal fragments were determined on control CT scans. Most of the deaths in this group of patients were attributed to the influence of brain injury and occurred within the first month after injury. Fragments retained after first debridement were followed periodically by CT scans. Surgery was not performed until the infection developed. Retained fragments did not increase the infection risk but high rates of infection did occur in cases with CSF fistulas. The presence of diffuse brain damage, brainstem injury, CNS infection, or ventricular injury was associated with a poor outcome. The prognostic importance of complications such as intracranial haemorrhage, epileptic seizures, hydrocephalus, was also investigated.

References

Sertaç Yetişer, , M. D. 

Department of Oto-Rhino-Laryngology and Head and Neck Surgery · GATA Medical School

06018 Etlik-Ankara

Turkey

Phone: +903-12-304-5706 ·

Fax: +903-12-418-6444

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