Der Unfallchirurg
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One hundred patients with multiple injuries (mean ISS 37 patients) were prospectively evaluated over a period of 14 days following trauma. Significant differences in the blood levels of PMN elastase, cathepsin B, lactate, neopterin, C-reactive protein (CRP) and antithrombin III (ATIII) were found in non-survivors and in survivors with and without organ failure. ⋯ The prognostic value of these factors was comparable to trauma scores regarding organ failure and better with respect to death. Biochemical parameters may be helpful in estimating the severity of the injury and prognosis and in monitoring the ICU course of such patients.
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Craniocerebral missile injuries are a relatively rare type of head injury during peacetime. In the Department of Neurosurgery of the Landesnervenklinik Salzburg 72 patients were operated on for gunshot wounds of the brain in the period 1970-1990, and 31 survived. In the same period 6763 patients were treated for other head injuries. As shown by the clinical courses and the operative results, the velocity and thus the extent of the primary brain damage determine the prospects of success in the treatment of cerebral missile injuries.