Summary
Patients who have suffered gunshot wounds in civilian settings, who present with posturing and in whom the bullet has passed through the geographical centre of the brain have generally not been felt to be salvageable. However, surprisingly favourable outcomes in two such patients have led us to believe that some such patients may deserve agressive treatment.
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References
Byrnes, D. P., Crockard, H. A., Gordon, D. S., Gleadhill, C. A., Penetrating craniocerebral missile injuries in the civil disturbances in Northern Ireland. Brit. J. Surg.61 (1974), 169–176.
Carey, M. E., Young, H. F., Mathis, J. L., The neurosurgical treatment of craniocerebral missile wounds in Vietnam. Surg. Gynec. Obstet.135 (1972), 386–390.
Caveness, W. F., Meirowsky, A. M., Rish, B. L., Mohr, J. P., Kistler, J. P., Dillion, J. D., Weiss, G. H., The nature of posttraumatic epilepsy. J. Neurosurg.50 (1979), 545–553.
Cooper, P. R., Maravilla, K., Cone, J., Computerized tomographic scan and gunshot wounds of the head: Indications and radiological findings. Neurosurgery4 (1979), 373–380.
Cushing, H., A study of a series of wounds involving the brain and its enveloping structures. Brit. J. Surg.5 (1918), 558–684.
Goodman, J. M., Kalsbeck, J., Outcome of self-inflicted gunshot wounds of the head. J. Trauma5 (1965), 636–642.
Gordon, D. S., Missile wounds of the head and spine. Brit. Med. J.1 (1975), 614–616.
Harsh, G. R. III, Through-and-through wounds. In: Neurological surgery of trauma (Coates, J. B., Meirowsky, A. M., eds.), pp. 161–164. Washington, D.C.: U.S. Government Printing Office. 1965.
Jett, H. H., van Hoy, J. M., Hamit, H. F., Clinical and socioeconomic aspects of 254 admissions for stab and gunshot wounds. J. Trauma12 (1972), 577–580.
Kaufman, H. H., Moake, J. L., Olson, J. D., Miner, M. E., du Cret, R. P., Pruessner, J. L., Gildenberg, P. L., Delayed and recurrent intracranial hematomas related to disseminated intravascular clotting and fibrinolysis in head injury. Neurosurgery 7 (1980), 445–449.
Kaufman, H. H., Olson, J. D., Makela, M. E., Pruessner, J. L., Moake, J. L., Miner, M. E., Haar, F. L., Gildenberg, P. L., Disseminated intravascular coagulation and fibrinolysis in head injury. Presented at the American Association of Neurological Surgeons, Boston, Mass., April 1981.
Kaufman, H. H., Sadhu, V. K., Clifton, G. L., Handel, J. F., Delayed intracerebral hematoma due to traumatic aneurysm caused by a shotgun wound: A problem in prophylaxis. Neurosurgery6 (1980), 181–184.
Kirkpatrick, J. B., Dimaio, V., Civilian gunshot wounds of the brain. J. Neurosurg.49 (1978), 185–198.
Lillard, P. L., Five years experience with penetrating craniocerebral gunshot wounds. Surg. Neurol.9 (1978), 79–83.
Matson, D. D., Wolkin, J., Hematomas associated with penetrating wounds of the brain. J. Neurosurg.3 (1946), 46–53.
Mierowsky, A. M., Caveness, W. F., Dillion, J. D., Rish, B. L., Mohr, J. P., Kistler, J. P., Weiss, G. H., Cerebrospinal fluid fistulas complicating missile wounds of the brain. J. Neurosurg.54 (1981), 44–48.
Miller, J. D., Butterworth, J. F., Gudeman, S. K., Faulkner, J. E., Choi, S. C., Selhurst, J. B., Harbison, J. W., Lutz, H. A., Young, H. F., Becker, D. P., Further experience in the management of severe head injury. J. Neurosurg.54 (1981), 289–299.
Purvis, J. T., Craniocerebral injuries due to missiles and fragments. In: Head injury, Conference proceedings (Caveness, W. F., Walker, A. E., eds.), pp. 133–141. Philadelphia, Pennsylvania: J. B. Lippincott. 1966.
Raimondi, A. J., Samuelson, G. H., Craniocerebral gunshot wounds in civilian practice. J. Neurosurg.32 (1970), 647–653.
Rish, B. L., Caveness, W. F., Dillion, J. D., Kistler, J. P., Mohr, J. P., Weiss, G. H., Analysis of brain abscess after penetrating craniocerebral injuries in Vietnam. Neurosurgery9 (1981), 535–541.
Wannamaker, G. T., Transventricular wounds of the brain. In: Neurological surgery of trauma (Coates, J. B., Mierowsky, A. M., eds.), pp. 165–178. Washington, D.C.: U.S. Government Printing Office. 1965.
West, C. G., A short history of the management of penetrating missile injuries of the head. Surg. Neurol.16 (1981), 145–149.
Yashon, D., Jane, J. A., Martonffy, D., White, R. J., Management of civilian craniocerebral bullet injuries. Am. Surg.38 (1972), 346–351.
Yashon, D., Jane, J. A., White, R. J., Arteriographic observations in craniocerebral bullet wounds. J. Trauma8 (1968), 238–255.
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Kaufman, H.H., Loyola, W.P., Makela, M.E. et al. Civilian gunshot wounds: The limits of salvageability. Acta neurochir 67, 115–125 (1983). https://doi.org/10.1007/BF01401671
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DOI: https://doi.org/10.1007/BF01401671