Score of Gressot et al for a Civilian with a Gunshot Wound to the Head

Description

Gressot et al reported a score for evaluating a civilian with a gunshot wound to the head. This can help to identify a patient who may benefit from more aggressive management. The authors are from Baylor College of Medicine, University of Kansas, Seton Brain and Spine Institute in Austin and MD Anderson Cancer Center.

Patient selection: civilian with gunshot wound to head

Parameters:

(1) age in years

(2) Glasgow Coma Scale (GCS)

(3) reaction of the pupils to light

(4) trajectory

Parameter	Finding	Points
age in years	<= 35 years	0
	> 35 years	1
GCS	3 or 4	1
	5 to 15	0
reaction of pupils to light	reactive	0
	nonreactive	1
trajectory	posterior fossa	2
	bihemispheric	2
	other	0

total score =

= SUM(points for all of the parameters)

Interpretation:

• minimum score: 0

• maximum score: 5

• The higher the score the worse the outcomes.

Score	Mortality	Good Outcome
0	25%	50%
1	25%	30%
2	50%	10%
3 to 5	75%	0%

Additional factors associated with a better outcome:

(1) trajectory through one hemisphere OR bifrontal trajectory

(2) initial ICP <= 20 mm Hg

(3) absence of transventricular trajectory

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Score of Gressot et al for a Civilian with a Gunshot Wound to the Head

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