Penetrating gunshot injuries to the brain.
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.
Kim
Tae-Won
TW
Department of Neurosurgery, Chonnam National University Hospital, Dong-ku, Gwangju, Korea.
Lee
Jung-Kil
JK
Moon
Kyung-Sub
KS
Kwak
Hyoung-Jun
HJ
Joo
Sung-Pil
SP
Kim
Jae-Hyoo
JH
Kim
Soo-Han
SH
D000293:Adolescent; D000328:Adult; D002648:Child; D005260:Female; D015600:Glasgow Coma Scale; D020197:Head Injuries, Penetrating / Q000175:diagnosis / Q000000981:diagnostic imaging / Q000601:surgery*; D006801:Humans; D008297:Male; D019635:Neurosurgical Procedures; D011379:Prognosis; D012189:Retrospective Studies; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome; D014948:Wounds, Gunshot