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Penetrating head injury

J D Ward, A H Chisholm, V T Prince

    Critical Care Nursing Quarterly
    |May 1, 1994
    PubMed
    Summary
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    Penetrating head injuries require immediate trauma care to prevent secondary insults like hypoxia. Early Glasgow Coma Scale scores and computed tomography scans guide treatment and surgical decisions for better outcomes.

    Area of Science:

    • Neurosurgery
    • Trauma Care
    • Public Health

    Background:

    • Penetrating head injuries, often from gun violence, are a major US public health concern.
    • Initial management mirrors closed head injury care, focusing on preventing secondary insults.
    • Standard trauma care protocols are essential for patients with penetrating head injuries.

    Purpose of the Study:

    • To outline the critical management principles for penetrating head injuries.
    • To detail diagnostic and surgical considerations.
    • To emphasize factors influencing patient outcomes.

    Main Methods:

    • Neurologic assessment includes Glasgow Coma Scale, pupillary function, brain stem, and motor power evaluation.
    • Computed tomography (CT) scan is the preferred radiologic diagnostic tool.

    Related Experiment Videos

  • Surgical indications are based on potential for improvement, patient stability, and injury accessibility.
  • Main Results:

    • Key management goals include controlling hypertension, maintaining cerebral oxygenation, and preventing secondary complications.
    • Patient's presenting neurologic status, particularly Glasgow Coma Scale score, is the most significant predictor of survival.
    • Some studies suggest withholding treatment for Glasgow Coma Scale scores below 5 or for transventricular gunshot wounds due to high mortality.

    Conclusions:

    • Optimal outcomes for penetrating head injuries depend on comprehensive treatment regimens.
    • Early and aggressive management is crucial for preventing secondary insults and improving functional recovery.
    • Patient's initial neurological status is paramount in determining prognosis and treatment strategies.