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Updated: Aug 8, 2026
Controlled Cortical Impact Model for Traumatic Brain Injury
Published on: August 5, 2014
Craniocerebral gunshot injuries in South Africa--a suggested management strategy
1Department of Neurosurgery, Groote Schuur Hospital and University of Cape Town.
Objective:
To determine the outcome of craniocerebral gunshot injuries, analyse factors that affect prognosis and suggest a management protocol.
Design:
A retrospective analysis of civilian craniocerebral gunshot injuries treated over a 7-year period.
Setting:
Groote Schuur Hospital's neurosurgery and trauma unit service.
Patients:
One hundred and eighty-one patients with craniocerebral gunshot injuries were admitted to the Department of Neurosurgery, Groote Schuur Hospital, University of Cape Town, over a 7-year period and a retrospective analysis of these patient records with regard to outcome and prognostic factors was carried out.
Results:
Seventy-six patients sustained non-penetrating injuries, 8 (11%) of whom had underlying cerebral injury on computed tomography (CT) scan. The prognosis was good in the case of non-penetrating injuries. One hundred and five patients sustained penetrating injuries and 57% (62) had a poor outcome. A Glasgow Coma Score (GCS) of 5 or less following resuscitation was associated with a 98% mortality rate. CT scan evidence of transventricular injury was associated with 100% mortality, bihemispheric injury with 90% mortality, and diffuse cerebral swelling with 81% mortality.
Conclusion:
Patients with non-penetrating craniocerebral gunshot injuries should all undergo a CT scan as 10% will have cerebral injury. The prognosis is normally good. In penetrating craniocerebral gunshot injuries a GCS of 5 or less, or a GCS of 8 or less with CT scan findings of transventricular or bihemispheric injury have such a poor outcome that conservative treatment is indicated.
