Department of Neurological Surgery, Neurosurgery Teaching Hospital, Baghdad, Iraq.
Department of Neurological Surgery, University of Louisville, Louisville, Kentucky, USA.
World Neurosurg. 2020 Jun;138:e119-e123. doi: 10.1016/j.wneu.2020.02.050. Epub 2020 Feb 17.
Since their advent in the 1920s, tear gas canisters (TGCs) have been frequently used in crowd control. Few reports have documented nonpenetrating injuries attributed directly to TGCs. In this study, we report a case series of fatal penetrating head injuries caused by TGCs.
We conducted a retrospective chart review of all the patients who were admitted to the Neurosurgery Teaching Hospital in Baghdad, Iraq, since the start of the antigovernment protests (October 2019). All patients who suffered penetrating head trauma caused by TGCs were included in our study. We collected patient demographics, wound location, neurologic examination, computed tomography (CT) scan findings, surgical management, and clinical outcomes.
We found 10 cases of penetrating head trauma caused by TGCs. All victims were men, with a mean age of 16 years (range, 14-19 years). The mean Glasgow Coma Scale score was 7 (range, 3-10). The neurologic examination revealed unilateral hemiplegia/hemiparesis and pupillary abnormality in 40% (n = 4) and 50% (n = 5) of the patients, respectively. CT scans revealed an extensive pattern of brain damage. Surgical intervention was done in 80% of cases (n = 8), which included removal of the TGC, wound debridement, and hemostasis. The in-hospital mortality rate was 100% (N = 10), with all fatalities occurring within 1-3 days of admission.
TGCs have the potential to cause lethal penetrating head injuries, calling for a reevaluation of their safety and methods of use in terms of human health.
自 20 世纪 20 年代问世以来，催泪瓦斯罐（TGC）已被频繁用于人群控制。很少有报道记录过直接归因于 TGC 的非穿透性损伤。在本研究中，我们报告了一系列由 TGC 引起的致命穿透性头部损伤的病例系列。
我们对自 2019 年 10 月反政府抗议开始以来，被收治到伊拉克巴格达神经外科教学医院的所有患者进行了回顾性图表审查。所有因 TGC 导致穿透性头部创伤的患者均纳入我们的研究。我们收集了患者的人口统计学资料、伤口位置、神经检查、计算机断层扫描（CT）扫描结果、手术管理和临床结果。
我们发现了 10 例由 TGC 引起的穿透性头部创伤。所有受害者均为男性，平均年龄为 16 岁（范围 14-19 岁）。格拉斯哥昏迷评分的平均值为 7（范围 3-10）。神经检查显示单侧偏瘫/轻偏瘫和瞳孔异常分别占 40%（n=4）和 50%（n=5）的患者。CT 扫描显示出广泛的脑损伤模式。80%的病例（n=8）进行了手术干预，包括 TGC 取出、伤口清创和止血。住院死亡率为 100%（n=10），所有死亡均发生在入院后 1-3 天内。
TGC 有可能造成致命的穿透性头部损伤，需要重新评估其对人类健康的安全性和使用方法。
