Gunshot Penetrating Brain Injury: Predictors of Outcome Based on CT Brain

Abstract Background: Initial presentation of the patient with gun shot wounds to the head (GSWH) is important key to for the decision making that carry hopeful functional outcome. A forementioned predictors, scoring system was ascheived to predict the outcome. Aim of Study: Identifying a novel classification of man-agement. Patients and Methods: The records of 140 patients with penetrating military missile head injuries treated by the authors by Facilities in Northern Sinai and Kasr Al-Ainy between 2011 and 2018. The data were collected respectively. We advocated a classification that involve the whole parenchyma in midaxial CT brain, zone 1 is the outermost zone that extend from inner table to external capsule, zone 2 is located from external capsule to the lateral edge of the thalamus and zone 3 is the innermost and the highly risk zone that extend from the lateral edge of thalamus to the midline. Results: We demonstrated the correlation between the Glascow Outcome Score (GOS) and different zones. We recorded 52 patients in zone 1, 37 patients in zone 2 and 51 patients presented in zone 3. The survivors in zone1 and zone 2 were 89 patients (63.5%) however the survivors in zone 3 were 51 (36.4%) and all of them presented with severe disa-bilities and also involve the vegetative patients and the 5 patients who died. Conclusions: Authors determined age, pupil, GCS score and bullet trajectory as the important predictors of functional outcome. The authors advocated a broader classification in CT brain to be correlated significantly with morbidity and mortality.