{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,25]],"date-time":"2026-04-25T14:12:39Z","timestamp":1777126359526,"version":"3.51.4"},"reference-count":32,"publisher":"Scientific Scholar","content-domain":{"domain":["surgicalneurologyint.com"],"crossmark-restriction":true},"short-container-title":[],"abstract":"<jats:sec id=\"st1\">\n<jats:title>Background: <\/jats:title>\n<jats:p>Cranial firearm injuries (CFAIs) are expected to be frequent during warfare; however, it is becoming increasingly common among civilian population in our part of the world. These injuries are associated with significant morbidity and mortality in addition to financial loss. The objective of our study is to evaluate the pattern of gunshot injuries to cranium and their outcome.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"st2\">\n<jats:title>Methods: <\/jats:title>\n<jats:p>The study was conducted on 114 patients presenting with CFAIs to Jinnah Postgraduate Medical Centre, Karachi, Pakistan, between June 2015 and January 2019. Patients were evaluated with respect to age, gender, pattern of injury, Glasgow coma scale on arrival, radiological and clinical assessment, surgical intervention, and Glasgow outcome score measured at 6 months follow-up.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"st3\">\n<jats:title>Results: <\/jats:title>\n<jats:p>Among patients with cranial gunshot, injuries most were males (76.3%). More than 50% patients aged between 18 and 35 years. About 46.5% of patients presented with moderate traumatic brain injury commonly involving the temporal lobe (36.8%). Of total 114 patients, 84.2% were managed conservatively but wound debridement was done in all patients. At 6 months, the overall mortality in our patients was 33.3%. Patients with good outcome (GOS 4 and 5) were 30.7% and 35.9% patients had bad outcome (GOS 2 and 3). Complication rate was 14.9% and the most common complication was disseminated intravascular coagulation in 5.2%.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"st4\">\n<jats:title>Conclusion: <\/jats:title>\n<jats:p>Surgical intervention has no significant benefit over conservative management on long-term mortality and should be limited to patients with large intracranial hematomas and intraventricular hematomas causing hydrocephalus.<\/jats:p>\n<\/jats:sec>","DOI":"10.25259\/sni_167_2020","type":"journal-article","created":{"date-parts":[[2020,6,27]],"date-time":"2020-06-27T05:01:29Z","timestamp":1593234089000},"page":"167","update-policy":"https:\/\/doi.org\/10.25259\/crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Outcome of cranial firearm injuries in civilian population based on a novel classification system"],"prefix":"10.25259","volume":"11","author":[{"given":"Farrukh","family":"Javeed","sequence":"first","affiliation":[{"name":"Department of Neurosurgery, Jinnah Postgraduate Medical Centre, Karachi, Sindh, Pakistan."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Asad","family":"Abbas","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Jinnah Postgraduate Medical Centre, Karachi, Sindh, Pakistan."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lal","family":"Rehman","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Jinnah Postgraduate Medical Centre, Karachi, Sindh, Pakistan."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Syed Raza Khairat","family":"Rizvi","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Jinnah Postgraduate Medical Centre, Karachi, Sindh, Pakistan."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ali","family":"Afzal","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Jinnah Postgraduate Medical Centre, Karachi, Sindh, Pakistan."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hafiza Fatima","family":"Aziz","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, The Aga Khan University Hospital, Karachi, Sindh, Pakistan."}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"10894","published-online":{"date-parts":[[2020,6,27]]},"reference":[{"key":"10.25259\/SNI_167_2020\/ref-1","doi-asserted-by":"crossref","first-page":"1138","DOI":"10.3171\/2014.1.JNS131869","article-title":"Predictors of outcome in civilian gunshot wounds to the head","volume":"120","author":"Aarabi","year":"2014","journal-title":"J Neurosurg"},{"key":"10.25259\/SNI_167_2020\/ref-2","doi-asserted-by":"crossref","first-page":"418","DOI":"10.1016\/0090-3019(92)90109-Z","article-title":"Predictors of mortality in severely head-injured patients with civilian gunshot wounds: A report from the NIH traumatic coma data bank","volume":"38","author":"Aldrich","year":"1992","journal-title":"Surg Neurol"},{"key":"10.25259\/SNI_167_2020\/ref-3","doi-asserted-by":"crossref","first-page":"222","DOI":"10.1016\/j.clineuro.2014.08.019","article-title":"Being a neighbor to Syria: A retrospective analysis of patients brought to our clinic for cranial gunshot wounds in the Syrian civil war","volume":"125","author":"Aras","year":"2014","journal-title":"Clin Neurol Neurosurg"},{"key":"10.25259\/SNI_167_2020\/ref-4","doi-asserted-by":"crossref","first-page":"281","DOI":"10.2176\/nmc.45.281","article-title":"High-velocity gunshot wounds to the head: Analysis of 135 patients","volume":"45","author":"Bakir","year":"2005","journal-title":"Neurol Med Chir (Tokyo)"},{"key":"10.25259\/SNI_167_2020\/ref-5","article-title":"Trafficking in Legal Medicine","author":"Beauthier","year":"2008"},{"key":"10.25259\/SNI_167_2020\/ref-6","first-page":"164","article-title":"Neurosurgical management of gunshot injuries to the head","volume":"26","author":"Brandt","year":"1983","journal-title":"Neurochirurgia (Stuttg)"},{"key":"10.25259\/SNI_167_2020\/ref-7","doi-asserted-by":"crossref","first-page":"15","DOI":"10.3171\/jns.1990.72.1.0015","article-title":"Penetrating craniocerebral injuries in the Israeli involvement in the Lebanese conflict, 1982-1985. 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