"Damage to the bone and soft tissues of the head by high-velocity projectiles is dependent on a number of factors, such as shape and size, however, the dominant factor is the amount of kinetic energy they deposit as they traverse tissues. Total energy (E) is proportional to the mass (m) of the object times the square of its velocity (v), expressed as E = 1/2mv2. In other words, most of the kinetic energy available is due to velocity, explaining why a small bullet can do far more damage than a much larger object (e.g. knife blade) and why the patterns of injury for high-velocity objects is different to low-velocity ones. Both will cause direct damage as they traverse brain, however, high-velocity projectiles will also be able to impart significant kinetic energy to bone fragments and cause a cavitary shockwave in their wake which can damage tissue at considerable distances from the injury tract 5."
"Damage to the bone and soft tissues of the head by high-velocity projectiles is dependent on a number of factors, such as shape and size, however, the dominant factor is the amount of kinetic energy they deposit as they traverse tissues. Total energy (E) is proportional to the mass (m) of the object times the square of its velocity (v), expressed as E = 1/2mv2. In other words, most of the kinetic energy available is due to velocity, explaining why a small bullet can do far more damage than a much larger object (e.g. knife blade) and why the patterns of injury for high-velocity objects is different to low-velocity ones. Both will cause direct damage as they traverse brain, however, high-velocity projectiles will also be able to impart significant kinetic energy to bone fragments and cause a cavitary shockwave in their wake which can damage tissue at considerable distances from the injury tract 5."
"Note: Please see the main article "imaging of gunshot injuries" for a general description of imaging features."
"The direction of tract(s) and the key structures they traverse along with the amount of haemorrhage, particularly if there are sizeable haematomas that need evacuation. This is particularly the case for extra-axial haemorrhages that may occur due to vascular injury."
"Note: Please see the main article "imaging of gunshot injuries" for a general description of imaging features."
"DSA is used when CTA fails to demonstrate a vascular injury and the suspicion remains high or endovascular treatment is being considered. Delayed DSA may also be performed to assess for complications such as AV fistula 4."
Expected headings
"Skull"
"Foreign bodies"
"Parenchyma and haematomas"
"CT angiography"
"Digital subtraction angiography"
"Complications"
"The incidence of gunshot injuries to the head is increasing in some countries, due to the ease of accessibility of firearms. In the civilian population, suicide and criminal activity account for the majority of cases and young male adults remain the most at risk 4."
"As is the case with low-velocity penetrating brain injuries, CT and CT angiography are the cornerstones of emergent imaging of all patients with penetrating injuries. Plain films have largely been replaced by CT and MRI and are usually not indicated until later in the admission if at all. Of particular importance is the possibility that the penetrating material is ferromagnetic precluding safe MRI."
"Vascular injuries include transection, pseudoaneurysm, dissection or thromboembolic occlusion."
"Damage to the bone and soft tissues of the head by high-velocity projectiles is dependent on a number of factors, such as shape and size, however, the dominant factor is the amount of kinetic energy they deposit as they traverse tissues. Total energy (E) is proportional to the mass (m) of the object times the square of its velocity (v), expressed as E = 1/2mv2. In other words, most of the kinetic energy available is due to velocity, explaining why a small bullet can do far more damage than a much larger object (e.g. knife blade) and why the patterns of injury for high-velocity objects is different to low-velocity ones. Both will cause direct damage as they traverse brain, however, high-velocity projectiles will also be able to impart significant kinetic energy to bone fragments and cause a cavitary shockwave in their wake which can damage tissue at considerable distances from the injury tract 5."
"There are numerous complications ranging from instant to delayed 4:"