Contemporary Management of Penetrating Brain Injury

Penetrating brain injury includes all traumatic brain injury that is not the result of a blunt mechanism. Concerning these injuries, gunshot wounds are by far the most prevalent. Despite law enforcement efforts, these injuries unfortunately continue to be commonplace in large trauma centers as well as in metropolitan and large community emergency departments. Great efforts have been undertaken to standardize the medical and Surgical management of these patients. The authors review the Guidelines of Penetrating Brain Injury published in 2001 and performed ail updated literature search concerning this topic. There is evidence to suggest based upon current data that aggressive antibiotic prophylaxis and avoidance of aggressive debridement of deep-seated bone and bullet fragments has improved morbidity and mortality over the last 35 years.