engleski

Self-inflicted gunshot to the head during the war and post-war period.

Thirty-five patients with self-inflicted gunshot injury were admitted to our hospital during 1991-1996. War conditions and availability of firearms influenced the in these injuries, nearly six times greater than in the previous 6-year peace time period (1985-90). Our menagement protocol consisted of radical debridement of the missile track and evacuation of haematomata. For in-driven bone fragments we followed a less radical approach, but, if a post-operative computed tomogram (CT)showed a cluster of retained bone fragments, we operated on this. Attention was paid to the development of intracranial infection perfoming in such cases a contrast enhanced brain computed tomography. Ten patients died early and 29 werw managed operatively. Twelve survived, and were followed-up for up to 60 months. No case of suicide recidivism was noted. We conclude that patients with a Glasgow Coma score of 3 should not be considered for operation. Per-operatively ultrasonography was very helpful in localizing and extracti8ng in-driven bone fragments. Post-operatively, a CT scan is needed to demonstrate retained bone fragments.

Adolescence; Adult; Age Distribution; Aged; Craniocerebral Trauma; Croatia; Female; Human; Male; Middle Age; Severity of Illness Index; Suicide; Attenpted; Survival Rate; Tomography; X-ray Computed; War; Wounds; Gunshot;

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