Background:Civilian gunshot wounds to the head refer to brain injury caused by projectiles such as gun projectiles and various fragments generated by explosives in a power launch or explosion.Gunshot wounds to the hea...Background:Civilian gunshot wounds to the head refer to brain injury caused by projectiles such as gun projectiles and various fragments generated by explosives in a power launch or explosion.Gunshot wounds to the head are the deadliest of all gun injuries.According to literature statistics,the survival rate of patients with gunshot wounds to the head is only 9%.Due to the strict management of various types of firearms,they rarely occur,so the injury mechanism,injury and trauma analysis,clinical management,and surgical standards are almost entirely based on military experience,and there are few related reports,especially of the head,in which an individual suffered a fatal blow more than once in a short time.We report a case with a return to almost complete recovery despite the patient suffering two gunshot injuries to the head in a short period of time.Case presentations:We present a case of a 53-year-old man who suffered two gunshot injuries to the head under unknown circumstances.On initial presentation,the patient had a Glasgow Coma Scale score of 6,was unable to communicate,and had loss of consciousness.The first bullet penetrated the right frontal area and finally reached the right occipital lobe.When the patient reflexively shielded his head with his hand,the second bullet passed through the patient’s right palm bone,entered the right frontotemporal area,and came to rest deep in the lateral sulcus.The patient had a cerebral hernia when he was admitted to the hospital and immediately entered the operating room for rescue after a computed tomography scan.After two foreign body removals and skull repair,the patient recovered completely.Conclusions:Gunshot wounds to the head have a high mortality rate and usually require aggressive management.Evaluation of most gunshot injuries requires extremely fast imaging examination upon arrival at the hospital,followed by proactive treatment against infection,seizure,and increased intracranial pressure.Surgical intervention is usually necessary,and its key points include the timing,method,and scope of the operation.展开更多
The effect of high dose dexamethasone(5 mg/kg wt,intravenous injection)to preventand treat secondary pathological damage due to craniocerebral injury was studied in an animal modelof craniocerebral injury caused by hi...The effect of high dose dexamethasone(5 mg/kg wt,intravenous injection)to preventand treat secondary pathological damage due to craniocerebral injury was studied in an animal modelof craniocerebral injury caused by high-velocity missiles in dogs.We observed the physiologicalchanges,analyzed the level of serum and cerebrospinal fluid lactate dehydrogenase,cstimated thepermeability of blood brain barrier(BBB)and studied brain pathology by light and electronmicroscopy.The rusults suggest that high dose dexarnethasone can help to restore the structure andfunction of BBB,protect the brain cells,lessen the secondary pathological damage in the respiratoryand circulatory systams,and reduce the production of lipoperoxides(LPO).展开更多
文摘Background:Civilian gunshot wounds to the head refer to brain injury caused by projectiles such as gun projectiles and various fragments generated by explosives in a power launch or explosion.Gunshot wounds to the head are the deadliest of all gun injuries.According to literature statistics,the survival rate of patients with gunshot wounds to the head is only 9%.Due to the strict management of various types of firearms,they rarely occur,so the injury mechanism,injury and trauma analysis,clinical management,and surgical standards are almost entirely based on military experience,and there are few related reports,especially of the head,in which an individual suffered a fatal blow more than once in a short time.We report a case with a return to almost complete recovery despite the patient suffering two gunshot injuries to the head in a short period of time.Case presentations:We present a case of a 53-year-old man who suffered two gunshot injuries to the head under unknown circumstances.On initial presentation,the patient had a Glasgow Coma Scale score of 6,was unable to communicate,and had loss of consciousness.The first bullet penetrated the right frontal area and finally reached the right occipital lobe.When the patient reflexively shielded his head with his hand,the second bullet passed through the patient’s right palm bone,entered the right frontotemporal area,and came to rest deep in the lateral sulcus.The patient had a cerebral hernia when he was admitted to the hospital and immediately entered the operating room for rescue after a computed tomography scan.After two foreign body removals and skull repair,the patient recovered completely.Conclusions:Gunshot wounds to the head have a high mortality rate and usually require aggressive management.Evaluation of most gunshot injuries requires extremely fast imaging examination upon arrival at the hospital,followed by proactive treatment against infection,seizure,and increased intracranial pressure.Surgical intervention is usually necessary,and its key points include the timing,method,and scope of the operation.
文摘The effect of high dose dexamethasone(5 mg/kg wt,intravenous injection)to preventand treat secondary pathological damage due to craniocerebral injury was studied in an animal modelof craniocerebral injury caused by high-velocity missiles in dogs.We observed the physiologicalchanges,analyzed the level of serum and cerebrospinal fluid lactate dehydrogenase,cstimated thepermeability of blood brain barrier(BBB)and studied brain pathology by light and electronmicroscopy.The rusults suggest that high dose dexarnethasone can help to restore the structure andfunction of BBB,protect the brain cells,lessen the secondary pathological damage in the respiratoryand circulatory systams,and reduce the production of lipoperoxides(LPO).
