Hematomas Associated with Penetrating Wounds of the Brain

An historical context of modern principles in the management of intracranial injury from projectiles

“…Major Donald Matson and Captain Julius Wolkin 55 wrote about an early series of 11 patients treated for penetrating head wounds who suffered from hematomas distant from the site of the wound. He concluded that when a bullet or fragment traverses the brain and lodges approximately 2-3 cm below the surface distant from the entry site, then it is useful to explore that area for hematoma evacuation and debridement, especially because it is more accessible than deep fragments.…”

Surgical Management of Penetrating Intracranial Bullet Injuries

“…Violent shock waves or cavitary tissue displacement in which the skull impacts on the brain parenchyma may also cause contusions to form at sites remote from the missile tract. 9 The same forces may also result in diffuse parenchymal injury, or "diffuse axonal shear injury." 10 In our study, radiologic examination showed that diffuse parenchymal damage was present in 6 (20%) cases and that this was associated with poor prognosis in the series.…”

One year experience of emergency service in patients with penetrating head trauma due to firearm

“…As a result of a shot through the head, various degrees of injuries occur according to the type of weapon, shooting distance, angle and speed of bullet entry to the head (10). Various degrees of skull fractures occur in the area of bullet entry to the head in connection with the bullet mass and speed.…”