Skip to main content
Log in

Causes of infections and management results in penetrating craniocerebral injuries

  • Published:
Neurosurgical Review Aims and scope Submit manuscript

Abstract

From February 1992 to December 1994, 148 patients with penetrating craniocerebral injuries were treated surgically with primary and secondary debridement including repair of dural defects and removal of retained intracranial bone and metal fragments. Dural defects were closed primarily or with temporalis fascia, pericranium, and cadaver graft. Cerebrospinal fluid fistulas were observed in 11(7.3 %) patients; 7 of these were infected. Central nervous system (CNS) infection was seen in 2 patients without CSF fistula. Excluding those 11 patients with CSF fistula, CNS infection was shown in 2 of the 137 cases (1.5 %). All patients underwent CT scans periodically. In 51 (34 %) of 148 patients, bone and metal fragments were determined on control CT scans. During this time, 12 patients died (8 %). Most of deaths were caused by the direct effect of brain injury and occured within the first month after injury. Fragments retained after first debridement were followed periodically by CT scan. Surgery was not performed until infection developed. Retained fragments did not increase the infection risk, but high rates of infection did occur in cases with CSF fistula.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Aarabi B: Causes of infections in penetrating head wounds in the Iran-Iraq War. Neurosurg 25 (1989) 923–926

    Google Scholar 

  2. Aarabi B: Comparative study of bacteriological contamination between primary and secondary exploration of missile head wounds. Neurosurg 20 (1987) 610–616

    Google Scholar 

  3. Brandvold B, L Levi, M Feinsod, ED George: Penetrating craniocerebral injuries in the Israeli involvement in the Lebanese conflict. 1982–1985. J Neurosurg 72 (1990) 15–21

    PubMed  Google Scholar 

  4. Carey M, H Young, JL Mathis, J Forsyte: A bacteriological study of craniocerebral missile wounds from Vietnam. J Neurosurg 34 (1971) 145–154

    PubMed  Google Scholar 

  5. Clark WC, MS Muhlbauer, CB Watridge, MW Ray: Analysis of 76 civilian craniocerebral gunshot wounds. J Neurosurg 65 (1986) 9–14

    PubMed  Google Scholar 

  6. Hagan R: Early complications following penetrating wounds of the brain. J Neurosurg 34 (1971) 132–141

    PubMed  Google Scholar 

  7. Hammon WM: Analysis of 2187 consecutive penetrating wounds of the brain from Vietnam. J Neurosurg 34 (1971) 127–131

    PubMed  Google Scholar 

  8. Hammon WM: Retained intracranial bone fragments: Analysis of 42 patients. J Neurosurg 34 (1971) 142–144

    PubMed  Google Scholar 

  9. Meirowsky AM: Secondary removal of retained bone fragments in missile wounds of the brain. J Neurosurg 57 (1982) 617–621

    PubMed  Google Scholar 

  10. Meirowsky AM, WF Caveness, JD Dillon, BL Rish, JP Mohr, JP Kistler, GH Weiss: Cerebrospinal fluid fistulas complicating missile wounds of the brain. J Neurosurg 54 (1981) 44–48

    PubMed  Google Scholar 

  11. Myers PW, J Brophy, AM Salazar: Retained bone fragments after penetrating brain wounds: long-term follow-up in Vietnam veterans. J Neurosurg 70 (1989) 319

    Google Scholar 

  12. Pitlyk PJ, S Tolchin, W Stewart. The experimental significance of retained intracranial bone fragments. J Neurosurg 33 (1970) 19–24

    PubMed  Google Scholar 

  13. Rish BL, WF Caveness, JD Dillon: Analysis of brain abscess after penetrating craniocerebral injuries in Vietnam. J Neurosurg 9 (1981) 535–541

    Google Scholar 

  14. Rish BL, JD Dillon, GH Weiss: Mortality following penetrating craniocerebralinjuries. J Neurosurg 59 (1983) 775–780

    PubMed  Google Scholar 

  15. Siccardi D, R Lavaliere, A Pau, F Lubinu, S Turtas, GL Viale: Penetrating craniocerebral missile injuries in civilians: A retrospective analysis of 314 cases. Surg Neurol 35 (1991) 455–46

    PubMed  Google Scholar 

  16. Taha JM, MI Saba, JA Brown: Missile injuries to the brain treated by simple wound closure: Results of a protocol during the Lebanese Conflict. J Neurosurg 29 (1991) 380–384

    Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Rights and permissions

Reprints and permissions

About this article

Cite this article

Gönül, E., Baysefer, A., Kahraman, S. et al. Causes of infections and management results in penetrating craniocerebral injuries. Neurosurg. Rev. 20, 177–181 (1997). https://doi.org/10.1007/BF01105561

Download citation

  • Received:

  • Accepted:

  • Issue Date:

  • DOI: https://doi.org/10.1007/BF01105561

Keywords

Navigation