Penetrating Gunshot Injuries to the Brain

Abstract

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.