ACUTE PHYSIOLOGICAL EFFECTS OF GUNSHOT AND OTHER PENETRATING WOUNDS OF THE BRAIN

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Abstract
Penetrating wounds of the brain were produced in dogs under morphine analgesia by means of a mechanical drill, pellet shot, 22 BB revolver and a 22 BB rifle. A sudden, intense, increased intracranial tension of brief duration at the instant of injury was observed to accompany gunshot injuries of the brain by the 22 BB revolver and BB rifle. The acute physiologic response is due to this intense momentary increase in intracranial tension at the instant of injury. This "explosive force" transmitted to a closed semifluid system is dispersed throughout the intracranial space, it acts upon all tissue and it is manifested by the response of the vital medullary centers. When the medulla was destroyed by the bullet, death occurred without hypertension because of dissolution of the vasomotor mechanism. Bullet injury following a bilateral decompression spared the medullary centers because the intracranial hypertension was in part prevented by the decompression. The results could be classified into profound, moderate and minimal physiologic effects. Profound effects were characterized by loss of respiratory and palpebral reflex activity, hypertension and death. In the moderate group the reflexes and respiratory functions were temporarily interrupted, a rise in. blood pressure occurred, some of the animals survived. In the minimal group, no significant changes in vital functions were noted, and these were produced by a penetrating drill or pellet shot.

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