Penetrating gunshot injuries to the brain

J Trauma. 2007 Jun;62(6):1446-51. doi: 10.1097/01.ta.0000222909.31666.db.


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.

MeSH terms

  • Adolescent
  • Adult
  • Child
  • Female
  • Glasgow Coma Scale
  • Head Injuries, Penetrating / diagnosis
  • Head Injuries, Penetrating / diagnostic imaging
  • Head Injuries, Penetrating / surgery*
  • Humans
  • Male
  • Neurosurgical Procedures
  • Prognosis
  • Retrospective Studies
  • Tomography, X-Ray Computed
  • Treatment Outcome
  • Wounds, Gunshot*