Demographics of Civilian Cranial Gunshot Wounds

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Abstract
The demographics and outcome of patients with gunshot wounds to the head over the past 10 years at Chicago's Cook County Hospital was examined. The study group consisted of 476 consecutive patients admitted to this urban level I trauma center with a diagnosis of penetrating craniocerebral missile injury. All patients followed a protocol that included aggressive surgical management when indicated. The Glasgow Outcome Score was used to assess outcome. There is an alarming rise in firearm violence in general and craniocerebral injury in particular. Some patients with severe neurologic deficits and massive cerebral damage can benefit from aggressive treatment and make a good recovery. A large proportion of this violence is most likely attributable to gang activity. Factors correlating with poor outcome included hypotension, apnea, bihemispheric injuries, or ventricular penetration. Although aggressive surgical and medical management improves the outcome of these patients, much more stringent preventative measures are required to control this violent epidemic.