Bullet, Nail & Bolt: Penetrating Brain Injuries in Austria

For the first time, type, cause and outcome caused by penetrating objects recorded. Study of the Karl Landsteiner University of Health Sciences Krems.
By: Karl Landsteiner University of Health Sciences
KREMS, Austria - Sept. 22, 2022 - PRLog -- Nearly half of all patients who are admitted alive to hospital after traumatic brain injury involving objects penetrating the brain are able to survive. That's one of the most surprising findings of a study by Karl Landsteiner University of Health Sciences Krems (KL Krems), the first in Austria to assess the nature, causes and recovery prospects of this type of injury. According to the study, it is important for treatment decisions to correctly assess the penetration velocity of the objects. Lower velocities cause injuries with significantly better healing prospects. In Austria, the frequency of injuries caused by bolt guns also stands out.

Objects (e.g., bullets, nails, bolts) penetrating the skull bone cause numerous different injuries to the brain, with healing prospects dependent on many variables. Nevertheless, few data exist to date on these types of injuries in the civilian sector. For Austria, a team from KL Krems now collected these data for the first time and published their conclusions internationally.

Life & Death

"In general, it must be said that penetrating brain injuries are fatal in many cases," explains Dr. Franz Marhold, Clinical Department of Neurosurgery at St. Pölten University Hospital, one of the teaching and research sites of KL Krems. "Three-quarters of those affected die while still at the scene of the accident, at least that's true in the civilian sector." But even for those who are still admitted alive to a hospital, the chances of survival were previously considered low. But it is precisely for this group that the now-published study provides surprising insights.

"Our results show a more differentiated picture of the survival chances of these patients," explains Dr. Marhold. "According to the study, the decisive factor is, among other things, the speed of entry of the object causing the damage. If this is low, then 70% of those affected in our study had a prospect of a good prognosis. For objects with high velocity, however, it was less than 20%."

Original publication: Surviving the Scene in Civilian Penetrating Brain Injury: Injury Type, Cause and Outcome in a Consecutive Patient Series in Austria. F. Marhold, F. Scheichel, B. Ladisich, P.  Pruckner, E. Strasser, M. Themesl, K. Ungersboeck & B. Popadic. DOI:10.3389/fsurg.2022.923949 (https://doi.org/10.3389/fsurg.2022.923949)

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