Citation

Dookie S, Ramklass S, Enicker B. Afr. J. Neurol. Sci. 2016; 35(2).

Copyright

(Copyright © 2016, Pan African Association of Neurological Sciences)

DOI

unavailable

PMID

unavailable

Abstract

Background and objective: Self-inflicted gunshot head injuries (SIGHIs) following suicidal intent (SI) have a high pre-hospital mortality; with survivors representing an exceptional entity. We investigated the prevalence, demographics, and characteristics of these injuries with regards to clinical presentation, computerised tomography (CT) findings, management, and outcomes at discharge.

METHODS This was a retrospective study of patients admitted to the Department of Neurosurgery at Inkosi Albert Luthuli Central Hospital during January 2003 to September 2014. Patients with craniocerebral gunshot injuries (CGIs) were identified and only those with a history of a SIGHI following SI were included in the study.

RESULTS A total of 499 cases of CGI were treated during this period; of which 31(6%) were SIGHI following SI. There were 28 (90%) males (M: F ratio = 9:1). The median age was 32 years, interquartile range (IQR) of 27 - 39 years, and median admission Glasgow Coma Scale (GCS) was 11 (IQR = 8 - 14). The frontal region formed the predominant entry site [12; 39%]. CT brain scan revealed intracerebral haematomas in the majority of patients [29; 93%] and eighteen patients (58%) sustained transaxial injuries. All patients were managed surgically. The median hospital stay was 10 days (IQR = 3 - 19). The median discharge GCS was 13 (IQR = 7 - 14). Seven (23%) patients demised during their stay; having a post resuscitation GCS ≤ 8 (P = 0.018) and age ≥ 39 (P = 0.026).

CONCLUSION This single-centre review highlights the devastating clinical impact of SIGHIs following SI. The post-resuscitation GCS remains an important prognosticating factor. © 2002-2012 African Journal of Neurological Sciences.

Language: en

Keywords

adult; human; violence; suicide; female; male; Review; resuscitation; head injury; mortality; hospitalization; major clinical study; controlled study; gunshot injury; retrospective study; hospital admission; automutilation; seizure; Parasuicide; hospital discharge; postoperative period; cohort analysis; Glasgow coma scale; debridement; Gunshot wound; false aneurysm; observational study; electronic medical record; descriptive research; meningitis; computed tomographic angiography; wound infection; brain abscess; facial nerve paralysis; pupil disease; hemiplegia; decompressive craniectomy; suicidal intent; brain artery aneurysm; cerebrospinal fluid fistula; cerebrospinal fluid otorrhea; cerebrospinal fluid rhinorrhea; craniocerebral gunshot injury; Craniocerebral injury; intracranial pressure; meningocele; middle cerebral artery pseudoaneurysm; open wound leak; scalp pseudomeningocele; transaxial injury; wound complication