{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,13]],"date-time":"2026-10-13T00:39:31Z","timestamp":1791851971454,"version":"4.3.4"},"reference-count":57,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2014,12,2]],"date-time":"2014-12-02T00:00:00Z","timestamp":1417478400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2014,12,2]],"date-time":"2014-12-02T00:00:00Z","timestamp":1417478400000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["World j. surg."],"published-print":{"date-parts":[[2015,6]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Aim<\/jats:title>\n                    <jats:p>To review the current management, prognostic factors and outcomes of penetrating and blast injuries to the central nervous system and highlight the differences between gunshot wound, blast injury and stabbing.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A review of the current literature was performed.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Of patients with craniocerebral GSW, 66\u201390 % die before reaching hospital. Of those who are admitted to hospital, up to 51 % survive. The patient age, GCS, pupil size and reaction, ballistics and CT features are important factors in the decision to operate and in prognostication. Blast injury to the brain is a component of multisystem polytrauma and has become a common injury encountered in war zones and following urban terrorist events. GSW to the spine account for 13\u201317 % of all gunshot injuries.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Urgent resuscitation, correction of coagulopathy and early surgery with wide cranial decompression may improve the outcome in selected patients with severe craniocerebral GSW. More limited surgery is undertaken for focal brain injury due to GSW. A non\u2010operative approach may be taken if the clinical status is very poor (GCS 3, fixed dilated pupils) or GCS 4\u20135 with adverse CT findings or where there is a high likelihood of death or poor outcome. Civilian spinal GSWs are usually stable neurologically and biomechanically and do not require exploration. The indications for exploration are as follows: (1) compressive lesions with partial spinal cord or cauda equina injury, (2) mechanical instability and (3) complications. The principles of management of blast injury to the head and spine are the same as for GSW. Multidisciplinary specialist management is required for these complex injuries.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1007\/s00268-014-2874-7","type":"journal-article","created":{"date-parts":[[2014,12,1]],"date-time":"2014-12-01T14:29:45Z","timestamp":1417444185000},"page":"1352-1362","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":100,"title":["Current Concepts in Penetrating and Blast Injury to the Central Nervous System"],"prefix":"10.1002","volume":"39","author":[{"given":"Jeffrey V.","family":"Rosenfeld","sequence":"first","affiliation":[{"name":"Department of Neurosurgery The Alfred Hospital Melbourne Australia"},{"name":"Department of Surgery Monash University 6th Floor, The Alfred Centre, 99 Commercial Road, Clayton Melbourne Australia"},{"name":"Department of Surgery, F. Edward H\u00e9bert School of Medicine Uniformed Services University of the Health Sciences Bethesda MD USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Randy S.","family":"Bell","sequence":"additional","affiliation":[{"name":"Department of Surgery, F. Edward H\u00e9bert School of Medicine Uniformed Services University of the Health Sciences Bethesda MD USA"},{"name":"Department of Neurosurgery MedStar\u2010Georgetown University Hospital and Washington Hospital Center Washington DC USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rocco","family":"Armonda","sequence":"additional","affiliation":[{"name":"Department of Surgery, F. 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