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Open-wound treatment for gunshot to the brain

Pepijn van den Munckhof1, Vincent G Geukers, Fonnet E Bleeker

  • 1Neurosurgical Center Amsterdam, Academic Medical Center, Room H2-241, Meibergdreef 9, 1105 AZ Amsterdam, The Netherlands. p.vandenmunckhof@amc.uva.nl

Journal of Neurosurgery. Pediatrics
|June 12, 2012
PubMed

Insights

A young girl with a brain gunshot wound survived after undergoing decompressive craniectomy and experimental open-wound treatment for elevated intracranial pressure. She achieved a good functional recovery, showcasing a novel treatment approach for severe traumatic brain injury.

Area of Science:

  • Pediatric neurosurgery
  • Trauma surgery
  • Emergency medicine

Background:

  • Gunshot wounds to the brain are rare and life-threatening injuries, particularly in young children.
  • Elevated intracranial pressure (ICP) is a critical complication that significantly increases mortality and morbidity.
  • Standard treatment protocols for pediatric traumatic brain injury (TBI) may require adaptation for complex penetrating injuries.

Observation:

  • A 2.5-year-old girl sustained a gunshot wound to the brain.
  • The patient presented with uncontrollably elevated intracranial pressure.
  • An emergent bilateral decompressive craniectomy was performed to manage the elevated ICP.

Findings:

  • The patient underwent an experimental open-wound treatment following the craniectomy.
  • The surgical intervention successfully reduced intracranial pressure.
  • The patient demonstrated a positive clinical response to the combined treatment approach.

Implications:

  • Bilateral decompressive craniectomy can be a life-saving procedure for pediatric TBI with refractory intracranial hypertension.
  • Experimental open-wound management may offer a viable option in select cases of severe TBI.
  • This case highlights the potential for good functional recovery even after devastating brain injuries with timely and aggressive intervention.

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