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Factors affecting dural penetration and prognosis in patients admitted to emergency department with cranial gunshot wound

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European Journal of Trauma and Emergency Surgery Aims and scope Submit manuscript

Abstract

Purpose

To explore the effect of admission physical examination findings, anamnesis, and computed tomography on dural penetration and prognosis in patients with cranial gunshot wound (CGW).

Methods

In this study, the medical data of 56 subjects who were admitted to the Emergency Department of Dicle University Hospital with CGWs between January 2011 and December 2013 were retrospectively reviewed. The effects of type of incident (suicidal vs non-suicidal), pupil diameter and light reflex, hemodynamic status, type (bullet or pellet), velocity, trajectory of foreign material, trauma scores, and imaging findings on dural penetration and mortality were explored.

Results

The mean age of the study population was 24.8 ± 13.50 years. Thirty (53.6 %) patients had penetrating injuries and 26 (46.4 %) had non-penetrating injuries; 9 (16.1 %) patients died and 47 (83.9 %) survived. Suicidal injury, pupil diameter and light reflex, bullet as foreign material, and high velocity and lateral trajectory of foreign material significantly affected dural penetration and mortality (p < 0.05). In addition, dural penetration, bilobar, multilobar, or bihemispheric involvement of brain parenchyma, presence of intracranial hemorrhage, subarachnoid hemorrhage, ventricular hemorrhage, fracture, shift, edema, and trauma scores significantly affected mortality (p < 0.05).

Conclusions

In CGWs, dural penetration and prognosis can be predicted by physical examination findings and patient characteristics on initial admission.

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Authors and Affiliations

  1. Department of Emergency Medicine, Faculty of Medicine, Dicle University, 21280, Diyarbakır, Turkey

    M. İçer, Y. Zengin, R. Dursun, H. M. Durgun & C. Güloğlu

  2. Department of Radiology, Faculty of Medicine, Dicle University, Diyarbakır, Turkey

    C. Göya

  3. Department of Biostatistics, Faculty of Medicine, Dicle University, Diyarbakır, Turkey

    İ. Yıldız

Authors
  1. M. İçer
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  2. Y. Zengin
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  3. R. Dursun
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  4. H. M. Durgun
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  5. C. Göya
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  7. C. Güloğlu
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Corresponding author

Correspondence to M. İçer.

Ethics declarations

There is no ethical approval because it was a retrospective study.

Conflict of interest

Mustafa İçer, Yılmaz Zengin, Recep Dursun, Hasan Mansur Durgun, Cemil Göya, İsmail Yıldız and Cahfer Güloğlu declare that they have no conflict of interest.

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İçer, M., Zengin, Y., Dursun, R. et al. Factors affecting dural penetration and prognosis in patients admitted to emergency department with cranial gunshot wound. Eur J Trauma Emerg Surg 43, 611–615 (2017). https://doi.org/10.1007/s00068-015-0564-2

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  • DOI: https://doi.org/10.1007/s00068-015-0564-2

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