Similarities between civilian gunshot wounds to the head and nongunshot head injuries

Alex B. Valadka, Shankar P. Gopinath, Yasufimi Mizutani, Ari G. Chacko, Claudia S. Robertson

Research output: Contribution to journalArticlepeer-review

16 Scopus citations


Background: This investigation compared the cerebral pathophysiologic status of gunshot wounds to the head (GSWH) with that of severe head injury of other causes (non-GSWH). Methods: Data were collected prospectively from 71 GSWH and 541 non-GSWH patients. The two groups had similar demographic characteristics and injury severities. Cerebral metabolic parameters for each patient were averaged for the entire period of monitoring. These per- patient averages were compared between GSWH and non-GSWH groups. Results: Median intracranial pressure was 21.4 mm Hg in GSWH patients vs. 16.7 mm Hg in non-GSWH patients (p < 0.001). Mean arterial pressures were similar, but the higher intracranial pressure in GSWH patients produced a lower median cerebral perfusion pressure. Cerebral blood flow, cerebrovascular resistance, cerebral metabolic rate of oxygen, average jugular venous oxygen saturation, and number of jugular venous desaturations did not differ significantly between the groups. Three-month outcome was death in 43% of GSWH patients and 32% of non-GSWH patients, persistent vegetative state or severe disability in 33% and 32%, respectively, and moderate disability or good recovery in 24% and 36%, respectively. These outcomes were not significantly different (p = 0.11). Conclusion: GSWH patients suffer global cerebral metabolic disturbances that are at least as severe as those seen in non-GSWH patients with injuries of comparable severity. This selected population of GSWH patients may enjoy outcomes comparable to those of non-GSWH patients if they are treated by the same aggressive protocols.

Original languageEnglish (US)
Pages (from-to)296-302
Number of pages7
JournalJournal of Trauma - Injury, Infection and Critical Care
Issue number2
StatePublished - Feb 2000
Externally publishedYes


  • Cerebral blood flow
  • Gunshot wound
  • Head injury
  • Intracranial pressure
  • Jugular venous oxygen saturation
  • Outcome

ASJC Scopus subject areas

  • Surgery
  • Critical Care and Intensive Care Medicine


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