Aarabi et al reported predictors associated with a poor outcome for a civilian with a gunshot wound to the head. The authors are from the University of Maryland, Office of the Chief Medical Examiner of the State of Maryland, Johns Hopkins University, Parkway Neuroscience and Spine Institute, Western Maryland Health and Georgetown University.

Patient selection: civilian gunshot wound to the head


Favorable outcome: Glasgow Outcome Score (GOS) of 4 or 5.


Predictors for a nonfavorable outcome from multivariate analysis:

(1) Glasgow coma scale (GCS) on admission from 3 to 8

(2) obliteration of the basal cistern (not open)


If GCS was removed from analysis, the following items were significant:

(1) abnormal pupillary response (APR) to light

(2) bullet path transgressing the x (coronal), y and z (sagittal) planes


Additional factors:

(1) intracranial hemorrhage, including intraventricular hematoma

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