Traumatic brain injury due to gunshot wounds: a single institution's experience with 442 consecutive patients.
OBJECTIVE
Traumatic brain injury (TBI) caused by a gunshot wound is a complex injury with a broad spectrum of symptoms and high rates of mortality and morbidity. This study presents an evaluation of TBI caused by gunshot wounds presenting at a single institution and discusses possible predictive factors for the outcome of surgical intervention.


METHODS
The study sample consisted of 442 patients who underwent surgery for TBI over a 16-year period. All injuries were caused by gunshot wounds, such as bullets and shrapnel. All patients underwent surgical intervention.


RESULTS
Almost all patients (99.3%) were male, and the mean patient age was 22.3 years. Wounds were caused by shrapnel in 68 percent of patients. The Glasgow Coma Scale (GCS) score at admission was below 8 in 116 patients (26.2%) and above 8 in 326 patients (73.8%). In total, 47 patients (10.6%) died despite surgical management, with diffuse brain injury the most common cause of death.


CONCLUSIONS
Low GCS scores, ventricular injuries and bihemispheric injuries are correlated with poor prognosis. Early and less invasive surgery in conjunction with short transportation time to the hospital could decrease mortality rates.
Solmaz
Ilker
I
Gülhane Military Medical Academy, Neurosurgery Department, Ankara, Turkey.
Kural
Cahit
C
Temiz
Cağlar
C
Seçer
Halil Ibrahim
HI
Düz
Bülent
B
Gönül
Engin
E
Izci
Yusuf
Y
D000293:Adolescent; D000328:Adult; D001930:Brain Injuries / Q000000981:diagnostic imaging / Q000401:mortality* / Q000601:surgery*; D002648:Child; D002675:Child, Preschool; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D008887:Military Medicine / Q000706:statistics & numerical data*; D011237:Predictive Value of Tests; D011379:Prognosis; D014057:Tomography, X-Ray Computed; D014421:Turkey / Q000453:epidemiology; D014948:Wounds, Gunshot / Q000000981:diagnostic imaging / Q000401:mortality* / Q000601:surgery*; D055815:Young Adult