{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,10]],"date-time":"2026-11-10T15:24:46Z","timestamp":1794324286529,"version":"4.9.0"},"reference-count":28,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","issue":"5","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["PED"],"published-print":{"date-parts":[[2016,11]]},"abstract":"<jats:sec>\n                    <jats:title>OBJECTIVES<\/jats:title>\n                    <jats:p>Penetrating traumatic brain injuries (TBIs) can be divided into gunshot wounds or stab wounds based on the mechanisms of injury. Pediatric penetrating TBIs are of major concern as many parental and social factors may be involved in the causation. The authors describe the penetrating cranial injuries in pediatric patient subgroups at risk and presenting to the Department of Neurosurgery at the University of KwaZulu-Natal, by assessment of the Glasgow Coma Scale (GCS) score and review of the common neurological manifestations including cranial nerve abnormalities.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>METHODS<\/jats:title>\n                    <jats:p>The authors performed a retrospective chart review of children who presented with penetrating TBIs between 1985 and 2007 at a university teaching hospital. Descriptive statistical analysis with univariate and multivariate logistic regression was used to assess the variables.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>RESULTS<\/jats:title>\n                    <jats:p>Out of 223 children aged 16 years and younger with penetrating TBIs seen during the study period, stab wounds were causal in 127 (57%) of the patients, while gunshot injuries were causal in 96 (43%). Eighty-four percent of the patients were male. Apart from abnormal GCS scores, other neurological abnormalities were noted in 109 (48.9%) of the patients, the most common being cranial nerve deficits (22.4%) and hemiparesis. There was a strong correlation between left-sided stab wounds and development of seizures. The mean age of patients with neurological abnormalities was 11.72 years whereas that of patients with no neurological abnormalities was 8.96 years.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>CONCLUSIONS<\/jats:title>\n                    <jats:p>Penetrating head injuries in children are not as uncommon as previously thought. There was no correlation between the age group of the patients and the mechanism of injury, which implies that stab or gunshot injuries could occur in any of our pediatric population with the same frequency. While gunshot injuries accounted for 56% of the patient population, stab injuries still accounted for 44%.<\/jats:p>\n                    <jats:p>Following penetrating head injuries, neurological abnormalities tend to occur in the older subgroup of the pediatric patients. The most common neurological abnormalities were hemiparesis followed by cranial nerve deficits. Facial nerve deficits were the most commonly seen cranial nerve abnormality. Immediate convulsions were a significant feature in patients with stab injuries to the head compared to those with gunshot injuries.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3171\/2016.5.peds167","type":"journal-article","created":{"date-parts":[[2016,7,29]],"date-time":"2016-07-29T09:58:14Z","timestamp":1469786294000},"page":"550-557","source":"Crossref","is-referenced-by-count":13,"title":["Neurological findings in pediatric penetrating head injury at a university teaching hospital in Durban, South Africa: a 23-year retrospective study"],"prefix":"10.3171","volume":"18","author":[{"given":"Kadhaya David","family":"Muballe","sequence":"first","affiliation":[{"name":"Department of Neurosurgery and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Timothy","family":"Hardcastle","sequence":"additional","affiliation":[{"name":"Trauma Surgery, Inkosi Albert Luthuli Central Hospital and University of KwaZulu-Natal, Durban, KwaZulu-Natal, South Africa"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Erastus","family":"Kiratu","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery and"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1754","reference":[{"key":"b1-peds167","series-title":"Neurosurgery","doi-asserted-by":"publisher","first-page":"1056","DOI":"10.1227\/00006123-198806010-00014","article-title":"Traumatic aneurysms of brain due to high velocity missile head wounds","volume":"22","author":"Aarabi","year":"1988"},{"issue":"3 Suppl","key":"b2-peds167","series-title":"Pediatr Crit Care Med","doi-asserted-by":"publisher","first-page":"S60","DOI":"10.1097\/00130478-200307001-00017","article-title":"Guidelines for the acute medical management of severe traumatic brain injury in infants, children, and adolescents. Chapter 16. The use of corticosteroids in the treatment of severe pediatric traumatic brain injury","volume":"4","author":"Adelson","year":"2003"},{"key":"b3-peds167","series-title":"Surg Neurol","doi-asserted-by":"publisher","first-page":"331","DOI":"10.1016\/S0090-3019(96)00357-6","article-title":"Air-gun pellet injuries to the head and neck","volume":"47","author":"Amirjamshidi","year":"1997"},{"key":"b4-peds167","series-title":"Seizure","doi-asserted-by":"publisher","first-page":"453","DOI":"10.1053\/seiz.2000.0458","article-title":"The risks of epilepsy after traumatic brain injury","volume":"9","author":"Annegers","year":"2000"},{"key":"b5-peds167","series-title":"N Engl J Med","doi-asserted-by":"publisher","first-page":"20","DOI":"10.1056\/NEJM199801013380104","article-title":"A population-based study of seizures after traumatic brain injuries","volume":"338","author":"Annegers","year":"1998"},{"key":"b6-peds167","series-title":"Lancet","first-page":"211","article-title":"Treatment of head wounds due to missiles: analysis of 500 cases","volume":"2","author":"Ascroft","year":"1943"},{"key":"b7-peds167","series-title":"J Neurosurg","doi-asserted-by":"publisher","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\u20131985. Analysis of a less aggressive surgical approach","volume":"72","author":"Brandvold","year":"1990"},{"key":"b8-peds167","series-title":"Ann Surg","doi-asserted-by":"publisher","first-page":"375","DOI":"10.1097\/00000658-194509000-00004","article-title":"Compound comminuted skull fractures produced by missiles: report based upon 100 cases","volume":"122","author":"Campbell","year":"1945"},{"key":"b9-peds167","series-title":"Br J Surg","first-page":"558","article-title":"A study of a series of wounds involving the brain and the enveloping structures","volume":"5","author":"Cushing","year":"1918"},{"key":"b10-peds167","series-title":"Pediatr Neurosurg","doi-asserted-by":"publisher","first-page":"45","DOI":"10.1159\/000120813","article-title":"Low-velocity penetrating craniocerebral injury in childhood","volume":"21","author":"Domingo","year":"1994"},{"key":"b11-peds167","series-title":"Neurosurgery","doi-asserted-by":"publisher","first-page":"905","DOI":"10.1227\/00006123-199211000-00012","article-title":"Penetrating stab wounds to the brain: the timing of angiography in patients presenting with the weapon already removed","volume":"31","author":"du Trevou","year":"1992"},{"key":"b12-peds167","series-title":"J Trauma","doi-asserted-by":"publisher","first-page":"981","DOI":"10.1097\/00005373-197511000-00007","article-title":"Penetrating intracranial foreign bodies in children","volume":"15","author":"Dujovny","year":"1975"},{"key":"b13-peds167","series-title":"Pediatric Neurosurgery: Surgery of the Developing Nervous System","first-page":"99","article-title":"Skull fractures and penetrating brain injury","author":"Dutcher","year":"2001"},{"key":"b14-peds167","series-title":"S Afr Med J","first-page":"293","article-title":"Inhuman shields\u2014children caught in the crossfire of domestic violence","volume":"94","author":"Fieggen","year":"2004"},{"key":"b15-peds167","series-title":"Neurochirurgia (Stuttg)","first-page":"66","article-title":"[Seizure prevention using carbamazepine following severe brain injuries.]","volume":"26","author":"Gl\u00f6tzner","year":"1983"},{"key":"b16-peds167","series-title":"J Neurosurg","doi-asserted-by":"publisher","first-page":"132","DOI":"10.3171\/jns.1971.34.2part1.0132","article-title":"Early complications following penetrating wounds of the brain","volume":"34","author":"Hagan","year":"1971"},{"key":"b17-peds167","series-title":"Neurosurgery","doi-asserted-by":"publisher","first-page":"431","DOI":"10.1227\/00006123-198810000-00004","article-title":"Stab wounds to the temporal fossa","volume":"23","author":"Haworth","year":"1988"},{"key":"b18-peds167","series-title":"Am J Dis Child","first-page":"1045","article-title":"Clinical predictors of severe head trauma in children","volume":"142","author":"Hennes","year":"1988"},{"key":"b19-peds167","series-title":"J Neurosurg","doi-asserted-by":"publisher","first-page":"42","DOI":"10.3171\/jns.1984.60.1.0042","article-title":"Vascular lesions due to transcranial stab wounds","volume":"60","author":"Kieck","year":"1984"},{"key":"b20-peds167","series-title":"J Emerg Med","doi-asserted-by":"publisher","first-page":"145","DOI":"10.1016\/S0736-4679(01)00363-8","article-title":"Penetrating head injury in children: a case report and review of the literature","volume":"21","author":"Koestler","year":"2001"},{"key":"b21-peds167","series-title":"Am J Dis Child","first-page":"687","article-title":"Incidence, severity, and external causes of pediatric brain injury","volume":"140","author":"Kraus","year":"1986"},{"key":"b22-peds167","series-title":"Pediatr Neurosurg","doi-asserted-by":"publisher","first-page":"391","DOI":"10.1159\/000095572","article-title":"Penetrating head injury from a pedestal fan rotor blade in a child\u2014an unusual case","volume":"42","author":"Kumar","year":"2006"},{"key":"b23-peds167","series-title":"J Neurosurg","doi-asserted-by":"publisher","first-page":"58","DOI":"10.3171\/jns.1946.3.1.0058","article-title":"Early complications following penetrating wounds of the skull","volume":"3","author":"Martin","year":"1946"},{"key":"b24-peds167","series-title":"J Neurosurg","doi-asserted-by":"publisher","first-page":"155","DOI":"10.3171\/jns.1973.38.2.0155","article-title":"Relation of prophylactic medication to the occurrence of early seizures following craniocerebral trauma","volume":"38","author":"Rish","year":"1973"},{"key":"b25-peds167","series-title":"Neurology","doi-asserted-by":"publisher","first-page":"1406","DOI":"10.1212\/WNL.35.10.1406","article-title":"Epilepsy after penetrating head injury. 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