Available online 9 January 2013
Publication year: 2013
Source:World Neurosurgery
Background Civilian craniocerebral gunshot injuries are rare but increasing in incidence in the developing world and there is scare literature on presentation, injury characteristics, prognostic indicators and complications of brain trauma due to projectiles. Methods A retrospective review of 51 civilian patients with craniocerebral gunshot injury who presented to the Aga Khan University Hospital between 1998 and 2011 was carried out. Presentation, injury characteristics and complications were analyzed with emphasis on outcomes and prognostic indicators. Results There were 43 male and 8 female patients with an average age of 28.92(±12.33) years. 23 patients had a GCS of (13-15), 6 patients had a GCS of (9-12) and 22 patients had a GCS of (3-8) on admission. The overall mortality rate was 22% (n=11). The most common post operative neurological deficits were motor deficits (19 patients) followed by aphasias (11 patients).Upon univariate analysis, admitting GCS and bi/multi lobar injuries were found to be highly predictive of neurological outcome. There was no difference in outcomes between penetrating and perforating injuries. We also failed to find a statistically significant correlation between ventricular injury and outcomes in our patients. Conclusion Admitting GCS and number of lobes involved are highly prognostic of outcome. Patients with a GCS score ≥9 and unilobar injury on CT scans may benefit the most from surgical management.
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