Abstract:
:Head injuries due to high-velocity missiles and shrapnel as a result of military conflicts have become a very important cause of death or severe neurological deficits. Military-type missiles have high velocities and transfer higher amounts of energy to neural tissue, compared to civil-type missiles. This physical phenomenon also causes greater neural tissue destruction. Shrapnel particles derive from blasts and cause less severe injury because of the irregular particle shape and low energy transmission. This study analyzed 135 patients with head trauma, 80 patients (59%) injured by missiles and 55 patients (41%) by shrapnel. Glasgow Coma Scale (GCS) scores at admission were 3 to 7 in 69 patients, 8 to 10 in 29 patients, and 11 to 15 in 37 patients. The most common anatomical localizations were the right frontoparietal region in 42 patients and the left frontoparietal region in 40 patients. One hundred patients (74%) were operated on immediately and 35 patients (26%) were treated conservatively in the intensive care unit. Ten of the 135 patients died (7.4%), seven from missile injury and three from shrapnel injury. In this study, we found that high mortality was associated with low GCS score at admission, presence of multilobar or skull base injuries, and involvement of ventricles. Early and aggressive surgical intervention decreased the mortality.
journal_name
Neurol Med Chir (Tokyo)journal_title
Neurologia medico-chirurgicaauthors
Bakir A,Temiz C,Umur S,Aydin V,Torun Fdoi
10.2176/nmc.45.281keywords:
subject
Has Abstractpub_date
2005-06-01 00:00:00pages
281-7; discussion 287issue
6eissn
0470-8105issn
1349-8029pii
JST.JSTAGE/nmc/45.281journal_volume
45pub_type
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