Abstract

A CLASSIFICATION SYSTEM FOR PENETRATING TRAUMATIC BRAIN INJURIES CAUSED BY TEAR-GAS CANISTERS

Ammar M. Al-Smaysim, Waleed K. Alhayali, Mustafa H. Lafta, Zahraa F. Al-Sharshahi*, Ali S. Abdulrazzaq, Aysar K. Jassam and Samer S. Hoz

ABSTRACT

Introduction: Tear Gas Canisters (TGCs) is a rare, albeit an important cause of penetrating traumatic brain injury (pTBI). Classification systems designed for other causes of pTBI are not necessarily applicable for TGC-induced TBI owing to the distinctive mechanism of injury, severity, and poor prognosis of these wounds. Aim: In this article we propose a comprehensive descriptive classification system for TGC-pTBI derived from our own clinical experience and a review of the existing literature. Methods: The study was conducted in a local tertiary care center in Baghdad; the Neurosurgery Teaching Hospital (NTH). We carried out a retrospective case analysis of the medical records of all patients admitted to NTH in Baghdad with TGC-pTBI since the start of anti-governmental demonstrations in October. Results: An overall of 41 Patients were included in the study; all of whom sustained serious CTG-pTBI. The proposed system consists of six classes and eight subclasses (Figure 1). A nomenclature of I-VI was used with A & B subclasses for categories I, V and VI. Importantly, the severity of the injuries and hence the prognosis progressed from classes 1-VI, with class VI having the worst clinical outcomes. Conclusion: In summary, we propose a classification system for TGC-pTBI based mainly on wound characteristics and clinical parameters. Our initial data suggest a prognostic value for many of classification system components. However, the validity and the ease of application of this system need to be prospectively evaluated.

Keywords: Tear Gas Canisters, traumatic brain injuries, classification systems, wound characteristics.