Wound ballistics of gunshot injuries to the head and neck.
ABSTRACT It is important for the trauma surgeon to understand the basic principles of terminal gunshot ballistics and the study of the projectile's effect on striking soft tissue. The amount of kinetic energy dissipated to the tissue is directly related to the mass and velocity of the projectile as follows: K = MV2/2. Doubling the velocity quadruples the energy, while doubling the mass only doubles the energy. A temporary tissue cavity is produced as the striking projectile compresses the surrounding tissue; the higher the energy release, the more extensive the inapparent compressive damage. The permanent cavity that remains is the result of extrusion of tissue from the pathway of the projectile. The higher the velocity, the higher the likelihood of extensive damage. If the missile expands or fragments within the tissues, more damage will occur.
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ABSTRACT: Though modern civilian neurosurgical practice frequently encounters unusual penetrating injuries of cranium and spine; penetrating nail injuries to neck are very rarely described. We describe the case of a 24 year old male who suffered such an injury from a nail gun. The history, radiological studies and treatment are presented. Mechanism of injury seems to share characteristics of low velocity projectiles. We discuss the management of this unusual case reviewing the current literature on penetrating neck injuries caused by similar objects.Indian Journal of Neurotrauma. 01/2009;
Article: Ballistics for the neurosurgeon.[Show abstract] [Hide abstract]
ABSTRACT: Craniocerebral injuries from ballistic projectiles are qualitatively different from injuries in unconfined soft tissue with similar impact. Penetrating and nonpenetrating ballistic injuries are influenced not only by the physical properties of the projectile, but also by its ballistics. Ballistics provides information on the motion of projectiles while in the gun barrel, the trajectory of the projectile in air, and the behavior of the projectile on reaching its target. This basic knowledge can be applied to better understand the ultimate craniocerebral consequences of ballistic head injuries.Neurosurgery 03/2008; 62(2):472-80; discussion 480. · 2.53 Impact Factor
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ABSTRACT: We report an air gun pellet in the ethmoid sinus. The entrance point was concealed in the conjunctiva of the medial canthus, sparing the eye and skin. The pellet traversed the ethmoid and was stopped by the cribriform plate. It was removed by an endoscopic approach without complications. The literature is reviewed. A high index of suspicion is required to identify penetrating foreign bodies in patients walking in with low-velocity gun injuries.Archiv für Klinische und Experimentelle Ohren- Nasen- und Kehlkopfheilkunde 11/2007; 264(10):1253-6. · 1.46 Impact Factor