title: Penetrating shrapnel injuries of the posterior fossa.
abstract: BACKGROUND
  Gunshot injuries of the posterior fossa are rare and may follow a fatal course. In posterior fossa gunshot injuries, cerebellar hematoma, contusion, obstruction of cerebrospinal fluid (CSF) circulation by the shrapnel, and intracranial hypertension caused by autoregulation loss lead to mortality in the early stage.
  
  
  METHODS
  In this study, four cases of patients who underwent surgical intervention after penetrating shrapnel injuries of the pure posterior fossa were evaluated.
  
  
  RESULTS
  All of the patients were male; their mean age was 26.5 ± 5 years. The lowest and highest Glasgow Coma Scale scores were 4 and 12, respectively. Neural injury was detected by computed tomography performed after systemic and neurological examination following admission to the emergency service. The shrapnel was found in the cerebellar tissue in three cases and in the fourth ventricle in one case. Following preoperative procedures, surgery was performed with the patient in the prone position. Postoperative monitoring revealed no CSF fistula, meningitis, or hydrocephalus. None of the patients required revision surgery. There were no postoperative mortalities.
  
  
  CONCLUSIONS
  Due to the small volume of the posterior fossa, acute pathologies may lead to rapid neurological deterioration and death. Early surgical intervention and close postoperative follow-up after penetrating shrapnel injuries of the posterior fossa play a significant role in reducing mortality and morbidity.
authors.affiliation: Department of Neurosurgery, Deva Hospital, Osmangazi mah. 14 nolu Cadde 162/1 Şehitkamil, Gaziantep, 27560, Turkey, memetsecer@yahoo.com.
authors.forename: M
authors.initials: M
authors.lastname: Seçer
authors.forename: M
authors.initials: M
authors.lastname: Ulutaş
authors.forename: F
authors.initials: F
authors.lastname: Alagöz
authors.forename: K
authors.initials: K
authors.lastname: Çınar
authors.forename: E
authors.initials: E
authors.lastname: Yayla
mesh_terms: D000328:Adult; D006259:Craniocerebral Trauma / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000601:surgery*; D015600:Glasgow Coma Scale; D006801:Humans; D020198:Intracranial Hemorrhage, Traumatic / Q000503:physiopathology / Q000517:prevention & control / Q000601:surgery*; D019586:Intracranial Hypertension / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000601:surgery*; D008297:Male; D012189:Retrospective Studies; D014057:Tomography, X-Ray Computed; D014946:Wound Infection / Q000503:physiopathology / Q000517:prevention & control / Q000601:surgery*; D014948:Wounds, Gunshot / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000601:surgery*; D014950:Wounds, Penetrating / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000601:surgery*