GUNSHOT WOUNDS TO THE HEAD IN CIVILIAN PRACTICE

AN AGGRESSIVE SURGICAL strategy was applied to cranial gunshot wound v ictims at Cook County Hospital in Chicago from 1983 to 1992. A series of 480 patients with an overall mortality rate of 34% is presented. A total of 150 patients underwent craniotomy with an operative mortality rate of 21%. Criteria for operation were Glasgow Coma Scale scores of 3 through 7 without hypotension or fixed and dilated pupils or Glasgo w Coma Scale scores of 8 through 15 with intracranial bone fragments o r significant clot. This study supports previous reports that even pat ients with severe neurological deficits and massive cerebral damage ca n benefit from aggressive treatment and make satisfactory recoveries.