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- Experience and successful treatment of craniocerebral gunshot injury at a regional trauma center in Korea: a case report and literature review
- Mahnjeong Ha, Seunghan Yu, Jung Hwan Lee, Byung Chul Kim, Hyuk Jin Choi
- J Trauma Inj. 2022;35(4):277-281. Published online November 22, 2022
- DOI: https://doi.org/10.20408/jti.2022.0057
- 1,813 View
- 55 Download
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Abstract
PDF - Craniocerebral gunshot injuries is gradually increasing in the civilian population with a worse prognosis than closed head trauma. We experienced a case of craniocerebral gunshot injury which a bullet penetrating from the submandibular area into the clivus of a patient. The patient did not show any symptom. However, serial laboratory findings showed an increase in blood lead level. We removed foreign bodies without any problems using an endoscopic transnasal transclival approach. Due to the extremely low frequency, guidelines for definitive management of gunshot injuries have not been presented in Korea yet. We introduce our surgical experience of a craniocerebral gunshot injury with an unusual approach for removing intracranial foreign bodies.
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Summary
- Experience of Penetrating Gunshot Wound on Head in Korea
- Hong Rye Kim, Seung Je Go, Young Hoon Sul, Jin Bong Ye, Jin Young Lee, Jung Hee Choi, Seoung Myoung Choi, Yook Kim, Su Young Yoon
- J Trauma Inj. 2018;31(2):82-86. Published online August 31, 2018
- DOI: https://doi.org/10.20408/jti.2018.31.2.82
- 6,565 View
- 60 Download
- 1 Citations
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Abstract
PDF
Craniocerebral gunshot injuries (CGIs) are extremely seldom happened in Korea because possession of individual firearm is illegal. So, CGIs are rarely encountered by Korean neurosurgeons or Korean trauma surgeons, though in other developing countries or Unites states of America their cases are indefatigably increasing. Management goal should focus on early aggressive, vigorous resuscitation. The treatments consist of immediate life salvage through correction of coagulopathy, intracranial decompression, prevention of infection and preservation of nervous tissue. There have been few studies involving penetrating CGIs in Korea. Here we present a case of penetrating gunshot wound in Korea. We present a 58-year-old man who was unintentionally shot by his colleague with a shotgun. The patients underwent computed tomography (CT) for assessment of intracranial injury. The bullet passed through the left parietal bone and right lateral ventricle and exited through the posterior auricular right temporal bone. After CT scan, he arrested and the cardiopulmonary resuscitation was conducted immediately. But we were unable to resuscitate him. This case report underscores the importance of the initial clinical exam and CT studies along with adequate resuscitation to make the appropriate management decision. Physicians should be familiar with the various injury patterns and imaging findings which are poor prognostic indicators.
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Summary
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- Civilian penetrating traumatic brain injury: A 5-year single-center experience
Omid Yousefi, Pouria Azami, Roham Borazjani, Amin Niakan, Mahnaz Yadollahi, Hosseinali Khalili
Surgical Neurology International.2023; 14: 28. CrossRef
Original Article- The Significance of Clinical Examination for Brain Lesion Differentiation of Patients with Head Trauma after Alcohol Intoxication
- Yoon Hyun Jung, Dong Kil Jeong, Jung Won Lee, Hyung Jun Moon, Jae Hyung Choi, Jun Hwan Song
- J Trauma Inj. 2016;29(4):99-104. Published online December 31, 2016
- DOI: https://doi.org/10.20408/jti.2016.29.4.99
- 1,984 View
- 11 Download
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Abstract
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- PURPOSE
There are many patients visited to ED in an alcohol intoxicated state. For these patients, it is difficult to predict by only clinical examination whether he/she would have brain lesion. The purpose of this study is to research whether it is possible to predict brain lesion by only clinical examination findings, with comparing patients with/without actual brain lesions.
METHODS
A retrospective study was performed at a university hospital for the period 11 months with the medical records. As for the inclusion group, head trauma patients with objectively proved drunk, judging by their blood ethanol concentration, and performed the brain CT were selected. In terms of medical record, Glasgow coma scale (GCS), the presence of neurologic abnormalities, the presence of lesion on brain CT of the patients, were examined. From laboratory results, blood ethanol concentration, platelet count, prothrombin time (PT), activated partial thromboplastin time (aPTT) and glucose concentration were identified.
RESULTS
For this study, there were total 80 patients of inclusion group. There was no statistically significant difference in terms of GCS score and neurological examination abnormalities, between the group with brain lesion and the group without brain lesion on brain CT.
CONCLUSION
Alcohol intoxicated patient with head trauma visits the ED, it is not possible to distinguish or determine whether brain lesion exists or not by only clinical findings. In order to check the lesion existence, the image examination, therefore, should be considered and performed. -
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