■高速导弹受伤通常在战争或类似战争的情况下遇到。积极复苏,早期疏散到神经外科中心,和神经外科原理的应用仍然是成功的原则。
■包括在我们位于北部的中心管理的14例颅脑导弹损伤的损伤谱和临床特征。受伤部位,GCS在介绍时,相关伤害,手术干预,住院时间,并对患者的恢复情况进行分析。
■5名患者遭受枪伤,九名患者遭受弹片伤害。13名患者深度昏迷,一个病人意识清醒.八名患者的入口伤口在额叶,在四个病人中,那是在面部颅骨区域.10例患者的格拉斯哥昏迷评分(GCS)小于8。13例患者需要手术干预,包括11例开颅减压术和4例颅底前颅底修补术。一名患者在初次复苏时死亡,一名患者在术后死亡。损伤的位置是结果的唯一最重要的决定因素。
■早期去骨瓣减压术提供了合理的康复机会。涉及轨道探索的侵略性清创,肝切除术,或去除保留的小条是没有好处的。颅底损伤和鼻窦间隙的侵犯使这些患者容易发生脑脊液漏和感染性后遗症。所有这些患者都需要积极的术后重症监护和康复。
UNASSIGNED: High-velocity missile injuries are commonly encountered in war or war-like situations. Aggressive resuscitation, early evacuation to neurosurgical center, and application of neurosurgical principles remain tenets of success.
UNASSIGNED: The spectrum of injuries and clinical profile of 14 such cases with
craniocerebral missile injuries managed at our center in the northern sector were included. Site of injury, GCS at presentation, associated injuries, surgical intervention, duration of hospitalization, and recovery of the patient were analyzed.
UNASSIGNED: Five patients had sustained gunshot wounds, and nine patients had sustained shrapnel injuries. Thirteen patients were deeply comatose, and one patient was conscious. The entry wound was in frontal lobe in eight patients, and in four patients, it was in the faciocranial area. Ten patients had Glasgow Coma Scale (GCS) less than 8 at presentation. Surgical intervention was required in 13 patients, including 11 decompressive craniectomies and anterior skull base repair in four patients with faciocranial entry wound. One patient expired during initial resuscitation, and one patient died in the postoperative period. Location of injury was the single most important determinant of outcome.
UNASSIGNED: An early decompressive craniectomy provides a reasonable chance of recovery. Aggressive debridement involving track explorations, lobectomies, or removal of retained shrapnels is not beneficial. Injuries to the skull base and violation of sinus spaces predispose these patients to cerebrospinal fluid leaks and infective sequelae. All these patients require aggressive postoperative intensive care and rehabilitation.