Kühne C A, Zettl R P, Baume B, Vogt F M, Taeger G, Ruchholtz S, Stolke D, Nast-Kolb D
Klinik für Unfallchirurgie, Universitätsklinikum Essen, Hufelandstrasse 55, 45122 , Essen, Germany.
Unfallchirurg. 2007 Apr;110(4):341-9; quiz 350. doi: 10.1007/s00113-007-1244-4.
Gunshot injuries to the head and brain are rare in Germany and the rest of western Europe. With the relatively low number of these injuries here, there are no standard methods of diagnosis and management, and there is some controversy over both. Quite a high proportion of such injuries result from suicide attempts and accidents. The main diagnostic procedure available is computed tomography of the head with contrast medium; in certain cases MRI is indicated. The operative management depends on the extent and prognosis of the injury; a ventricular drain is probably indicated in most cases. Debridement of the bullet's path and removal of the projectile are more controversial. Mortality is extremely high after such injuries; if the victim does survive the prognosis is comparable to that following closed cranial injuries.
在德国及西欧其他国家，头部和脑部枪伤较为罕见。鉴于此类损伤数量相对较少，这里没有标准的诊断和处理方法，且在这两方面都存在一些争议。相当大比例的此类损伤是由自杀未遂和意外事故导致的。主要的可用诊断程序是头部增强计算机断层扫描；在某些情况下需进行磁共振成像检查。手术处理取决于损伤的程度和预后；在大多数情况下可能需要进行脑室引流。子弹通道的清创和弹头的取出更具争议性。此类损伤后的死亡率极高；若受害者幸存，其预后与闭合性颅脑损伤后的预后相当。
