In our study, radiological examination showed that diffuse brain damage and brainstem injuries were present in 34 (51.5%) and 23 (34.9%) patients, respectively, and it was associated with increased mortality rate.
3.4.1 Computerized tomography (CT) scan:
Different types of imaging studies are used in TBI patients due to missile wounds. In a hemodynamically stable patient, non-contrast enhanced CT scan is the preferred imaging modality.4-7,13,14,19, 20, 23, 32,44,46-48 Also, it provides a quick and noninvasive method of assessing information on the lesion extension, general trajectory of the missile, presence of hematoma and type of head injury. Additionally, it can provide useful information for the planning of the surgical procedure and usually helps define patient prognosis.5,6,8,28,30,32,35,44,46
Ambrosi et al. recommended a sequential evaluation with daily CT scan in a series of 110 patients with civilian gunshot wounds to the head.3 Additionally, Turco et al. considered the CT scan as the gold standard for patients with TBI due to gunshot wounds.35 Furthermore, 3-dimensional reconstruction CT scan may be helpful, particularly in the case of complex skull fractures.14
In our study, non-contrast CT scans were performed in all 384 conservatively treated patients. As for surgically treated patients, we could not …show more content…
reported that MRI is contraindicated in patients with intracranial metallic foreign bodies because of the potential risk for migration and further injury.28 They concluded that its use in TBI due to missile wounds is