title: Principles for managing penetrating craniocerebral injuries caused by firearm missiles.
abstract: Penetrating craniocerebral firearm injuries remain one of the most lethal causes of all trauma and are common both in war or peace time. Data were reviewed for 4140 severely head-injured patients (Glasgow Coma Scale (GCS) scores 3-8) treated at Xi-Jing Hospital between 1973 and 1993; 51 of these patients had acute penetrating craniocerebral injuries caused by firearm missiles. These patients consisted of 46 males (90.2%) and 5 females (9.8%) ranging in age from 3 months to 48 years (median 22.4 years). The lesion types included 2 tangential wounds, 37 tubular wounds and 12 through-and-through wounds. All cases were urgent with the patients in severe and unstable states. After emergency treatment and operation, 5 cases died (9.8%). Follow up studies at three months showed that 23 cases (45.1%) had made a good recovery. Moderate disability, severe disability and vegetative states in this series were 29.4%, 13.7% and 2.0% respectively. Long term follow up studies indicated that 32 were able to resume their occupation. The principles for managing penetrating craniocerebral firearm injuries and suggestions for operation are discussed.
authors.affiliation: Department of Neurosurgery Xi-Jing Hospital of Fourth Military Medical University, P.R. China.
authors.forename: X
authors.initials: X
authors.lastname: Zhang
authors.forename: S Y
authors.initials: SY
authors.lastname: Yi
authors.forename: W P
authors.initials: WP
authors.lastname: Liu
authors.forename: Z W
authors.initials: ZW
authors.lastname: Zhang
authors.forename: L G
authors.initials: LG
authors.lastname: Wang
authors.forename: A M
authors.initials: AM
authors.lastname: Li