Gunshot Penetrating Brain Injury: Predictors of Outcome Based on CT Brain | ||||
| The Medical Journal of Cairo University | ||||
| Article 84, Volume 89, December, December 2021, Page 2935-2941 PDF (443.66 K) | ||||
| DOI: 10.21608/mjcu.2021.225232 | ||||
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| Author | ||||
| MOHAMED GABR, M.D. AMR MOHSEN, M.D. | ||||
| The Department of Neurosurgery, Faculty of Medicine, Cairo University | ||||
| Abstract | ||||
| Abstract Background: Initial presentation of the patient with gun shot wounds to the head (GSWH) is important key to for the decision making that carry hopeful functional outcome. A forementioned predictors, scoring system was ascheived to predict the outcome. Aim of Study: Identifying a novel classification of man-agement. Patients and Methods: The records of 140 patients with penetrating military missile head injuries treated by the authors by Facilities in Northern Sinai and Kasr Al-Ainy between 2011 and 2018. The data were collected respectively. We advocated a classification that involve the whole parenchyma in midaxial CT brain, zone 1 is the outermost zone that extend from inner table to external capsule, zone 2 is located from external capsule to the lateral edge of the thalamus and zone 3 is the innermost and the highly risk zone that extend from the lateral edge of thalamus to the midline. Results: We demonstrated the correlation between the Glascow Outcome Score (GOS) and different zones. We recorded 52 patients in zone 1, 37 patients in zone 2 and 51 patients presented in zone 3. The survivors in zone1 and zone 2 were 89 patients (63.5%) however the survivors in zone 3 were 51 (36.4%) and all of them presented with severe disa-bilities and also involve the vegetative patients and the 5 patients who died. Conclusions: Authors determined age, pupil, GCS score and bullet trajectory as the important predictors of functional outcome. The authors advocated a broader classification in CT brain to be correlated significantly with morbidity and mortality. | ||||
| Keywords | ||||
| Gun shot; Penetrating; Outcome; Zone; Classification | ||||
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