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Gunshot Injuries to the Head

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Penetrating Trauma

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Abstract

Traumatic brain injury (TBI) remains a major cause of death and disability worldwide, and missile-induced TBI remains the most deadly of all traumas since first reported and has always been associated with high mortality and morbidity. The prevalence of TBI secondary to gunshots is strikingly variable and reflects the global scenery of violence. Injuries from gunshot wounds (GSW) to the head place an extreme economic burden on the public while disabling the victims in the zenith of their life and imposing enormous medical, legal, and emotional costs. Since every gun/projectile combination is associated with a typical pattern of injury, war injuries differ significantly from others. We will focus here on predominantly penetrating civilian gunshot wounds with low muzzle velocity (<1,000 f/s) as they occur in the setting of homicide and suicide attempts or during accidents. Many surgeons did take patients to the OR over the last 30 years, and they have achieved a remarkable reduction in morbidity from well above 50 % to less than 25 % in patients admitted with severe brain injury. However, in the setting of increasingly limited resources, recent research focus has shifted toward more precise prediction of survival as well as on better functional outcome.

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Author information

Authors and Affiliations

  1. Division of Neurosurgery, Department of Surgery, Beth Israel Deaconess Medical Center, Harvard Medical School, 110 Francis Street, Boston, MA, 02215, USA

    Ekkehard M. Kasper, Yosef Laviv & Martina Stippler

  2. Department of Neurology, University of Erlangen, Schwabachanlage 6, Erlangen F.R.G., 91054, Germany

    Burkhard S. Kasper

Authors
  1. Ekkehard M. Kasper
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  2. Yosef Laviv
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  3. Martina Stippler
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  4. Burkhard S. Kasper
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Corresponding author

Correspondence to Ekkehard M. Kasper .

Editor information

Editors and Affiliations

  1. Professor of Surgery Division of Trauma, Emergency Surgery and Surgical Critical Care, Massachusetts General Hospital Harvard University Medical School, Boston, USA

    George C. Velmahos

  2. Professor Emeritus, Department of Surgery, University of the Witwatersrand Medical School, Milpark Hospital Academic Trauma Centre and Leratong Hospital, Johannesburg, South Africa

    Elias Degiannis

  3. Honorary Senior Lecturer, Department of Surgery, University of the Witwatersrand Medical School, Johannesburg, South Africa

    Dietrich Doll

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Kasper, E.M., Laviv, Y., Stippler, M., Kasper, B.S. (2017). Gunshot Injuries to the Head. In: Velmahos, G., Degiannis, E., Doll, D. (eds) Penetrating Trauma. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-662-49859-0_27

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  • DOI: https://doi.org/10.1007/978-3-662-49859-0_27

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  • Publisher Name: Springer, Berlin, Heidelberg

  • Print ISBN: 978-3-662-49857-6

  • Online ISBN: 978-3-662-49859-0

  • eBook Packages: MedicineMedicine (R0)

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