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DOI: 10.1055/s-2004-830222
Craniocerebral Gunshot Wounds: Results of Less Aggressive Surgery and Complications
Publication History
Publication Date:
19 May 2005 (online)
![](https://www.thieme-connect.de/media/min/200502/lookinside/thumbnails/10.1055-s-2004-830222-1.jpg)
Abstract
Four hundreds patients who suffered from cranial gunshot wounds injuries were analyzed. Surgical therapy, primary and secondary debridement, including repair of dural defects and removal of retained intracranial bone and metal fragments were applied. Central nervous system infections were mostly observed in cases with cerebrospinal fluid (CSF) fistulas. In 130 of 400 patients, bone and metal fragments were determined on control CT scans. Most of the deaths in this group of patients were attributed to the influence of brain injury and occurred within the first month after injury. Fragments retained after first debridement were followed periodically by CT scans. Surgery was not performed until the infection developed. Retained fragments did not increase the infection risk but high rates of infection did occur in cases with CSF fistulas. The presence of diffuse brain damage, brainstem injury, CNS infection, or ventricular injury was associated with a poor outcome. The prognostic importance of complications such as intracranial haemorrhage, epileptic seizures, hydrocephalus, was also investigated.
Key words
Craniocerebral injury - prognostic factors - gunshot wounds - complications
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Sertaç Yetişer, M. D.
Department of Oto-Rhino-Laryngology and Head and Neck Surgery · GATA Medical School
06018 Etlik-Ankara
Turkey
Phone: +903-12-304-5706 ·
Fax: +903-12-418-6444
Email: syetiser@yahoo.com