Catapano Joshua S, Hutchens Danielle M, Cadigan Megan S, Srinivasan Visish M, Albuquerque Felipe C, Bristol Ruth E
Department of Neurosurgery, Barrow Neurological Institute, St. Joseph's Hospital and Medical Center, 350 W. Thomas Rd, Phoenix, AZ, 85013, USA.
Childs Nerv Syst. 2021 Apr;37(4):1279-1283. doi: 10.1007/s00381-020-04974-z. Epub 2020 Nov 27.
Pediatric intracranial injuries due to penetrating gunshot wounds are a rare entity that is often fatal. A subset of patients may experience an intracerebral arterial injury; however, literature on the pediatric population is limited. This study analyzes a large institution's experience with pediatric head gunshot wounds and intracranial arterial injuries.
All pediatric patients ≤ 18 years of age who presented to our institution with a penetrating gunshot wound from 2008 to 2018 were retrospectively analyzed.
Thirty-seven patients presented with an intracerebral penetrating gunshot injury. There were 18 deaths (49%) in the cohort. A total of 20 patients (54%) had vascular imaging. Of the remaining 17 patients with no vascular imaging, 13 (35%) died before any vascular studies were obtained. Four (20%) of the 20 patients with vascular imaging experienced an intracerebral arterial injury. Three of these 4 patients died before treatment could be administered. One patient with a firearm injury underwent embolization of a distal middle cerebral artery pseudoaneurysm and was discharged home with a Glasgow Outcome Scale score of 5 on follow-up.
Pediatric patients with penetrating intracranial gunshot wounds often die before vascular imaging can be obtained.
儿童穿透性枪伤所致颅内损伤是一种罕见且常致命的情况。部分患者可能会发生脑动脉损伤；然而，关于儿童人群的文献有限。本研究分析了一家大型机构处理儿童头部枪伤和颅内动脉损伤的经验。
对2008年至2018年期间因穿透性枪伤就诊于本机构的所有18岁及以下儿科患者进行回顾性分析。
37例患者出现脑穿透性枪伤。该队列中有18例死亡（49%）。共有20例患者（54%）进行了血管成像。其余17例未进行血管成像的患者中，13例（35%）在进行任何血管检查之前死亡。20例进行血管成像的患者中有4例（20%）发生脑动脉损伤。这4例患者中有3例在能够进行治疗之前死亡。1例火器伤患者接受了大脑中动脉远端假性动脉瘤栓塞术，随访时格拉斯哥预后评分5分出院。
儿童穿透性颅内枪伤患者常在能够进行血管成像之前死亡。
