الفهرس 
IntroductionOnly 14 pages are availabe for public view
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Abstract
Examination is mandatory to determine the extent of head penetration, location of the penetrating foreign body and need for surgical intervention.The aim of the current study is to evaluate the incidence of penetrating head injuries among polytraumatized patients and to follow up and determine the different outcomes of patients with penetrating head injuries This study included 63 patients traumatic penetrating head injury who were recruited over 1 year duration starting from November 2019 to October 2020 in Mansoura University Emergency Hospital and El-Sheikh Zayed specialized Hospital, Egypt .All patients were subjected to the initial resuscitation that conducted concurrently with primary assessment. After initial resuscitation effort, all patients were subjected to full history taking including age, gender, mode and time of trauma, time of arrival and resuscitation. Full laboratory investigations were done and CT brain was done to detect any lesions in the skull and the brain tissue.The results of this study revealed the following: There were 52 males (82.5%) and 11 females (17.5%) with mean age of 38.34 ± 15.1 years.The assault was the most common mode of trauma in the included cases (52.4%), accidental injuries in 12 cases (19.1%), road traffic accidents in 11 cases (17.4%) and falling on sharp objects in 7 cases (11.1%).The missiles (firearm) injuries were responsible for traumatic brain injuries in 74.6% of the cases.The highest percentage of the cases (41.3%) had GCS ≤ 8.Regarding the findings of types of skull fractures showed that beveling (bullet inlet and/or exit) in was the most common finding in 74.6% of the cases followed by depressed fracturs in 49.2% of the cases.Regarding the findings of the CT brain findings in the cases in the study, epidural hemorrhage was detected in 58.7% of the cases followed by subarachnoid hemorrhage in 53.9% of the cases.Surgical interference was required in 31.7% of the cases.The incidence of mortality was 50.8%.The mean age in the non-survived group was statistically significantly higher as compared with the survived group.The percentage of missiles (firearm) injuries in the non-survived group was statistically significantly higher as compared with the survived group.The GCS on admission was statistically significant lower in the non-survivor group as compared with the survivor group.The percentage of cases with unreactive pupils in the non-survivor group was statistically significantly higher as compared with the survival group.The incidence of Subarachnoid haemorrhage, intracerebral haemorrhage and brain laceration was statistically significantly higher in the non-survivors group as compared with survivors group.The length of hospital stay and length of ICU stay were statistically significant longer in the non-survivors.The percentage of cases who required mechanical ventilation was statistically significant higher in the non-survivor group.The requirement for surgical interference didn’t show a statistically significant difference between the two groupsCONCLUSION Penetrating brain injuries are serious injuries which carry a high morbidity and mortality. Gunshot injuries to the head in particular carry a poor prognosis. CT plays an important role in the initial evaluation of stable patients in determining the entry and exit wounds and extent of injury. The treatment of these patients is highly variable and often is determined on a case-by-case basis; however, the Glasgow Coma Scale in conjunction with CT imaging findings is a widely accepted means of triaging patients for surgical management.