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Successful Surgical Treatment of Severe Perforating Diametric Craniocerebral Gunshot Wound Sustained during Combat: A

Andrii Sirko1, Igor Kyrpa1, Ihor Yovenko2

  • 1Neurosurgery Department, Mechnikov Dnipropetrovsk Regional Clinical Hospital, Dnipro, Ukraine.

Military Medicine
|March 17, 2019
PubMed

Insights

This case report details the successful treatment of a severe perforating diametric craniocerebral gunshot wound in a Ukrainian soldier. It highlights a rare survival outcome for a typically fatal injury, offering insights into neurotrauma management.

Area of Science:

  • Neurosurgery
  • Trauma Surgery
  • Emergency Medicine

Background:

  • Perforating diametric craniocerebral gunshot wounds are associated with extremely high mortality rates (>96%).
  • Most patients succumb to these injuries before reaching medical facilities, classifying them as generally fatal.

Observation:

  • A 23-year-old male soldier presented with a severe, comatose state (Glasgow Coma Scale score of 5) due to a perforating diametric craniocerebral gunshot wound.
  • The patient received immediate neurosurgical intervention including helical computed tomography, primary wound treatment, duraplasty, and drainage.

Findings:

  • The patient survived the critical initial phase and underwent 18 days of intensive care unit treatment.
  • Successful primary management and subsequent rehabilitation were achieved, representing an unusual recovery from this devastating injury.

Implications:

  • This case challenges the absolute fatalistic classification of perforating diametric craniocerebral gunshot wounds.
  • It underscores the potential for successful outcomes with prompt and aggressive neurosurgical intervention in severe head trauma.
  • The findings may inform future treatment protocols for high-energy penetrating brain injuries.

Keywords:
brain helical computed tomographycraniocerebral injurygunshot woundneurosurgical treatment

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