Damage control of civilian penetrating brain injuries in environments of low neuro-monitoring resources

José D. Charry, Andrés M. Rubiano, Juan C. Puyana, Nancy Carney, P. David Adelson

Research output: Contribution to journalArticle

11 Citations (Scopus)

Abstract

Introduction. Gunshot wounds to the head are more common in military settings. Recently, a damage control (DC) approach for the management of these lesions has been used in combat areas. The aim of this study was to evaluate the results of civilian patients with penetrating gunshot wounds to the head, managed with a strategy of early cranial decompression (ECD) as a DC procedure in a university hospital with few resources for intensive care unit (ICU) neuro-monitoring in Colombia. Materials and methods. Fifty-four patients were operated according to the DC strategy (2 test. Results. Forty (74.1%) of the patients survived and 36 (90%) of them had favourable GOS. Factors associated with adverse outcomes were: Injury Severity Score (ISS) greater than 25, bi-hemispheric involvement, intra-cerebral haematoma on the first CT, closed basal cisterns and non-reactive pupils in the emergency room. Conclusion. DC for neurotrauma with ECD is an option to improve survival and favourable neurological outcomes 12 months after injury in patients with penetrating traumatic brain injury treated in a university hospital with few resources for ICU neuro-monitoring.

Original languageEnglish (US)
JournalBritish Journal of Neurosurgery
DOIs
StateAccepted/In press - Oct 14 2015

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Penetrating Head Injuries
Gunshot Wounds
Decompression
Intensive Care Units
Head
Penetrating Wounds
Injury Severity Score
Colombia
Pupil
Hematoma
Hospital Emergency Service
Survival
Wounds and Injuries

ASJC Scopus subject areas

  • Clinical Neurology
  • Surgery

Cite this

Damage control of civilian penetrating brain injuries in environments of low neuro-monitoring resources. / Charry, José D.; Rubiano, Andrés M.; Puyana, Juan C.; Carney, Nancy; David Adelson, P.

In: British Journal of Neurosurgery, 14.10.2015.

Research output: Contribution to journalArticle

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