PSYCHOPATHOLOGIC SEQUELAE OF GUNSHOT CRANIOCEREBRAL WOUNDS (GCCW)

O.N. Zaitsev, T.A, Dobrokhotova, G.G. Shaginyan, S.V, Urakov, I.N. Fisenko

Burdenko Research Institute of Neurosurgery

Data of psychopathologic examination of 67 survivors (alive during a period of more than 2 months) made it possible to reveal the peculiarities typical of GCCW:

  1. a high rate of cases with a short period of impaired consciousness (less than a week in almost a half of them, absence in 5 patients); coma was either absent or lasted less than a day in a half of observations (52%) and its duration of more than 7 days was watched in 5 patients (<8%);
  2. a high probability (41%) of a period of clear consciousness preceding its severe inhibition;
  3. rarity of productive forms of consciousness disturbances: it was possible to speak of consciousness dullness only in 6 cases (9%); its structure was amorphous and did not fall under any known type of consciousness dullness;
  4. early manifestations of focal psychopathologic signs: impaired speech (40% of cases), Korsakoff’s syndrome (27%), unilateral spatial agnosia (24%), marked emotional and personality disturbances (57%);
  5. predominance of cases with moderate reduction of intellect and memory and mild emotional and personality disturbances in acute and remote periods;
  6. a high risk of developing paroxysmal disturbances in a remote period; they were diagnosed in 29% of cases a year after trauma;
  7. correspondence between a psychopathologic picture and localization of the brain injury in the absence of signs of left-handedness or pyo-inflammatory intracranial complications;
  8. high percentage of satisfactory or relatively satisfactory outcomes at the end of the first year after trauma; working ability was restored in 64% of patients;
  9. unfavourable outcomes in injuries of median structures of the brain or development of pyo-inflammatory intracranial complications.