Bihemispheric gunshot wounds: survival and long-term neuropsychological follow-up of three siblings.

Academic Article

Abstract

  • PURPOSE: Penetrating gunshot wounds to the head (GSWH) have notoriously poor outcomes with extremely high mortality. Long-term follow-up data of affected children is scant in the medical literature. This report summarizes clinical presentation, management, and long-term outcomes from three children who survived "execution style" frontal, bihemispheric gunshot wounds with no or minimal surgical intervention. METHODS: A retrospective chart review of available medical records and outcomes from standardized, validated psychological instruments was undertaken, summarized, and evaluated. RESULTS: Despite bihemispheric injuries in each patient, no patient required operative intervention. Each child survived without readily evident neurologic impairment; however, the extent of impaired executive function varied widely, and severe disinhibition remains profoundly disabling in one survivor. CONCLUSIONS: Bihemispheric penetrating gunshot injuries are not uniformly fatal and can occasionally be associated with long-term favorable survival; however, impaired executive function has significant potential to be profoundly disabling in these injuries.
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    Keywords

  • Child, Child, Preschool, Cognition Disorders, Female, Glasgow Coma Scale, Humans, Infant, Longitudinal Studies, Male, Neuropsychological Tests, Retrospective Studies, Siblings, Survival, Tomography Scanners, X-Ray Computed, Wounds, Gunshot
  • Digital Object Identifier (doi)

    Authorlist

  • Gordon AS; Tofil N; Marullo D; Blount JP
  • Start Page

  • 1589
  • End Page

  • 1594
  • Volume

  • 30
  • Issue

  • 9