title: Civilian craniocerebral gunshot wounds.
abstract: Experience with 120 patients who incurred a gunshot wound to the head with dural penetration is presented. All of the patients were managed by a standard resuscitation protocol and assigned a clinical grade based on their level of consciousness both at the time of presentation and at 2 to 4 months after injury. Fifty patients (42%) underwent surgery. Twenty-eight patients (23%) had a good recovery, 19 (16%) were moderately disabled, 6 (5%) were severely disabled, and 67 (56%) died. All patients who were alert and awake with a normal or near normal neurological examination at the time of admission survived with a good outcome. All but 4 patients who were comatose at the time of admission died. Nine patients, however, who were not comatose at the time of admission died from potentially preventable causes. In 3 of these patients, a more aggressive diagnostic approach (including cerebral angiography) may have altered their ultimate outcome. An expeditious approach to the trauma victim with a comprehensive management scheme after injury may have altered the course in the remainder of these patients.
authors.affiliation: Division of Neurosurgery, University of New Mexico School of Medicine, Albuquerque.
authors.forename: E C
authors.initials: EC
authors.lastname: Benzel
authors.forename: W T
authors.initials: WT
authors.lastname: Day
authors.forename: L
authors.initials: L
authors.lastname: Kesterson
authors.forename: B K
authors.initials: BK
authors.lastname: Willis
authors.forename: C W
authors.initials: CW
authors.lastname: Kessler
authors.forename: D
authors.initials: D
authors.lastname: Modling
authors.forename: T A
authors.initials: TA
authors.lastname: Hadden
mesh_terms: D000328:Adult; D000368:Aged; D001930:Brain Injuries / Q000401:mortality / Q000601:surgery*; D002423:Cause of Death; D005260:Female; D006801:Humans; D008297:Male; D011183:Postoperative Complications; D011379:Prognosis; D012189:Retrospective Studies; D015996:Survival Rate; D014948:Wounds, Gunshot / Q000401:mortality / Q000601:surgery*