PRINCIPLES FOR MANAGING PENETRATING CRANIOCEREBRAL INJURIES CAUSED BYFIREARM MISSILES

Penetrating craniocerebral firearm injuries remain one of the most let hal causes of all trauma and are common both in war or peace time, Dat a were reviewed for 4140 severely head-injured patients (Glasgow Coma Scale (GCS) scores 3-8) treated at Xi-Jing Hospital between 1973 and 1 993; 51 of these patients had acute penetrating craniocerebral injurie s caused by firearm missiles, These patients consisted of 46 males (90 .2%) and 5 females (9.8%) ranging in age from 3 months to 48 years (me dian 22.4 years), The lesion types included 2 tangential wounds, 37 tu bular wounds and 12 through-and-through wounds. All cases were urgent with the patients in severe and unstable states. After emergency treat ment and operation, 5 cases died (9.8). Follow up studies at three mon ths showed that 23 cases (45.1%) had made a good recovery, Moderate di sability, severe disability and vegetative states in this series were 29.4%, 13.1% and 2.0% respectively, Long term follow up studies indica ted that 32 were able to resume their occupation, The principles for m anaging penetrating craniocerebral firearm injuries and suggestions fo r operation are discussed. (C) Pearson Professional 1996