Certain risk factors may increase the risk of infection following a craniocerebral gunshot wound.
Major risk factors for infection:
(1) dural defect with CSF leak
(2) defect in scalp closure
(3) environmental contamination
(4) inadequate or delayed debridement
A brain abscess may develop around retained bone or bullet fragments, sometimes much later. The surgeon must balance fragment removal versus the amount of cerebral trauma caused. Many surgeons will leave fragments of brain or bone rather than risk neurological impairment.
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