The experimental significance of retained intracranial bone fragments

Pitlyk, Paul J.; Tolchin, Sidney; Stewart, William R.

doi:10.3171/jns.1970.33.1.0019

Cited by 33 publications

(12 citation statements)

References 13 publications

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“…4 Varying degrees of cavitation in the brain occur along the bullet's path, usually several times larger than the diameter of the bullet. [4][5][6][7] In our series, a bullet was the wounding agent in 50% of the patients with anteroposterior and 67% of the patients with lateral injury.…”

Section: Discussionmentioning

confidence: 59%

Comparison of clinical outcomes between anteroposterior and lateral penetrating craniocerebral gunshot wounds

İzci

2005

Emergency Medicine Journal

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Objective: To investigate and compare, using a retrospective clinical study, the clinical outcomes of penetrating craniocerebral gunshot wounds (PCGW) with respect to the trajectory of penetration in the axial plane. Methods: In total, 22 patients with PCGW caused by conflict, suicide attempt, or accidental firing were included in this study. They were divided into two groups: anteroposterior and lateral. All patients underwent surgical treatment following emergency intervention. Results: Of the 22 patients, 16 had anteroposterior and 6 had lateral penetrating injury. Four patients with anteroposterior and five patients with lateral injury died despite surgical treatment. Mortality rate was 25% in the anteroposterior and 83% in the lateral injury group. Conclusion: We found that lateral PCGW is the most devastating type of missile injury to the head.

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Section: Discussionmentioning

confidence: 59%

Comparison of clinical outcomes between anteroposterior and lateral penetrating craniocerebral gunshot wounds

İzci

2005

Emergency Medicine Journal

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“…Not only skin flora but also nosocomial bacteria could cause deep intracranial infections if cerebrospinal fluid (CSF) pathways are seeded by dangerous Gram-positive cocci or Gram-negative bacilli (Cushing, 1936;Ascroft, 1943;Martin and Campbell, 1946;Small and Turner, 1947;Carey et al, 1974b;Meirowsky et al, 1981;Brandvold et al, 1990;Aarabi et al, 1998;Carey, 2003). Inadequate debridement may leave skin debris and foreign material inside the brain track, predisposing factors that raise the risk of brain abscess (Pitlyk et al, 1970;Carey, 2003). Most metallic fragments that penetrate brain tissue seem not to be contaminated and do not need to be removed (Taha et al, 1991b;Amirjamshidi et al, 2003).…”

Section: Pathologymentioning

confidence: 99%

Surgical management of civilian gunshot wounds to the head

Aarabi

Mossop

Aarabi

2015

Handbook of Clinical Neurology

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“…Maltby [6] found only 3 cases of retained bone fragment in a group of 17 cases of brain abscess during World War II. Experimental studies by Pitlyk et al [7] also noted only 4-8% incidence with sterile and contaminated bone fragments if not combined with hair or scalp. Phase I and II Vietnam head injury study did not find any evidence to incriminate retained bone fragment in the development of brain abscess [8,9].…”

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confidence: 97%

Missile Injuries of Brain – an Experience in Northern Sector

Singh

Misra²,

Singh

et al. 2003

Medical Journal Armed Forces India

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During a period of one year, from Jan 99 to Dec 99, 60 cases of missile injuries were treated at our centre. 59 were males and one was a female and their average age was 25 years. 43 patients had suffered splinter injuries, 12 had gunshot wounds and 5 had suffered injuries by improvised explosive devices. Glasgow coma scale was < 5 in 8 patients, 5-8 in 14, 8-12 in 30 and 13-15 in 8 patients. Extensive comminution of skull bones was found in 10 patients. 35 patients had more or less clear penetration of the skull and the rest had orbito-cranial or facio-cranial wounds. CT scan revealed small haemorrhagic contusion with in-driven bones without mass effect in 15, contusion with mass effect in 36 cases, cortical contusions without in driven bones (tangential injuries) in 3, distant intracranial contusions in 4, intraventricular haemorrhages in 5, multilobar injuries in 14, and unilobar injury in 40. 52 patients were operated upon at our centre of which 30 were operated within 24 hours, 10 between 24 to 48 hours, 12 between 48-72 hours. Six patients were treated conservatively and 2 required only simple closure of scalp wound. Craniectomy was done in 10 and craniotomy in 42 patients. Two patients developed wound sepsis, one each developed aspiration pneumonia, septicemia, deep vein thrombosis and post-traumatic hydrocephalus. On follow up at 6 months, outcome as per Glasgow outcome scale was as follows : good outcome -42, moderate disability in 7, severe disability in 6 and death in 5 patients. Retained bone fragments were found in 40% on follow up CT scan but none had brain abscess. MJAFI 2003; 59 : 290-297

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The experimental significance of retained intracranial bone fragments

Cited by 33 publications

References 13 publications

Comparison of clinical outcomes between anteroposterior and lateral penetrating craniocerebral gunshot wounds

Comparison of clinical outcomes between anteroposterior and lateral penetrating craniocerebral gunshot wounds

Surgical management of civilian gunshot wounds to the head

Missile Injuries of Brain – an Experience in Northern Sector

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