Emanuel H. Feiring

Gunshot Wounds of the Brain and Their Complications

While gunshot wounds of the head are not uncommon in civil practice, our knowledge thereof is derived largely from war experience. During World War I, the management of craniocerebral injuries by specialists was initiated. Principles of treatment were formulated and accounts of their experiences published by Cushing (1918), Horrax (1919), and Jefferson (1919) among others. Sepsis was exceedingly frequent and, in a large measure, was responsible for the high mortality rate. In Cushing’s series of 133 durai penetrating wounds, there were 55 postoperative fatalities (41.4 percent). Forty-three of these deaths were caused by infection (32.3 percent).