{
  "abstract": "Background\n\nCaptive bolt guns (CBG), designed for animal slaughter, are occasionally misused in self-harm or assault. Data on associated cranial injuries remain limited. This study provides the largest multicenter analysis to date of CBG-related penetrating brain injuries, focusing on epidemiological, clinical, and radiological characteristics and predictors of outcome.Methods\n\nA retrospective multicenter study was conducted across seven Czech Level 1 trauma centers between 2005 and 2025. Clinical, radiological, and epidemiological data were analyzed. Correlation and ROC analyses identified predictors of mortality and poor functional outcome (GOSE ≤ 4). Thirty-day mortality and long-term survival after self-inflicted CBG injury were compared with those of patients with self-inflicted conventional firearm brain injuries treated at Military University Hospital Prague.Results\n\n77 patients (mean age 58; 75 male) were included. Most injuries were self-inflicted (97%) and had midline entry sites (70%). Thirty-day mortality was 56%, and poor neurological outcome occurred in 78%. Lower admission GCS, basal cistern compression, diffuse subarachnoid hemorrhage, larger intracerebral hematoma volume, and longer intracranial tract length were associated with poor outcome. Surgical treatment was associated with lower 30-day mortality. ROC-derived thresholds were 11.5 mL for hematoma volume and 60.5 mm for tract length. Five-year Kaplan-Meier mortality was 78.2% after self-inflicted CBG injury and 82.1% after conventional firearm injury (log-rank p = 0.228).Conclusions\n\nCBG injuries represent a rare but distinct subtype of penetrating brain trauma characterized by unique radiological features and delayed mortality. These findings may improve prognostic assessment and support early clinical decision-making in patients with CBG-related brain injury.",
  "abstract_shown": true,
  "affiliations": [
    "Department of Neurosurgery and Neurooncology, First Faculty of Medicine, Charles University and Military University Hospital Prague, Prague, Czech Republic.",
    "Department of Neurosurgery, University Hospital Brno, Brno, Czech Republic.",
    "Faculty of Medicine, Masaryk University, Brno, Czech Republic.",
    "Department of Neurosurgery, University Hospital Hradec Králové, Czech Republic.",
    "Department of Neurosurgery, Faculty of Medicine in Pilsen, Charles University and University Hospital in Pilsen, Czech Republic.",
    "Department of Neurosurgery, Masaryk Hospital Ústí nad Labem, Czech Republic.",
    "Department of Neurosurgery, University Hospital Ostrava, Czech Republic.",
    "Second Faculty of Medicine, Charles University, Prague, Czech Republic.",
    "Department of Neurosurgery, České Budějovice Hospital, České Budějovice, Czech Republic."
  ],
  "article_type": "research article",
  "arxiv": null,
  "author_total": 12,
  "authors": [
    {
      "affs": [
        0
      ],
      "name": "Norbert Svoboda"
    },
    {
      "affs": [
        0
      ],
      "name": "Jakub Petrzelka",
      "orcid": "0009-0003-4294-5686"
    },
    {
      "affs": [
        1,
        2
      ],
      "name": "Ivana Roskova"
    },
    {
      "affs": [
        3
      ],
      "name": "Pavel Poczos"
    },
    {
      "affs": [
        4
      ],
      "name": "Jiri Dostal"
    },
    {
      "affs": [
        5
      ],
      "name": "Hynek Zitek"
    },
    {
      "affs": [
        6
      ],
      "name": "Stefan Reguli"
    },
    {
      "affs": [
        7
      ],
      "name": "Anhelina Khadanovich"
    },
    {
      "affs": [
        8
      ],
      "name": "Marek Grubhoffer"
    },
    {
      "affs": [
        0
      ],
      "name": "Martin Cerny"
    },
    {
      "affs": [
        0
      ],
      "name": "David Netuka"
    },
    {
      "affs": [
        0
      ],
      "name": "Martin Majovsky",
      "orcid": "0000-0001-7725-5181"
    }
  ],
  "bibtex": "https://research.draconitic.com/paper/2tmszy7h77r5c.bib",
  "cited_by": 0,
  "doi": "10.1016/j.bas.2026.107453",
  "fulltext_url": "https://europepmc.org/articles/PMC13677420",
  "id": "2tmszy7h77r5c",
  "issns": [
    "2772-5294"
  ],
  "landing_url": "https://europepmc.org/article/MED/42898170",
  "language": "eng",
  "licence": "CC-BY-NC-ND",
  "licence_label": "CC BY-NC-ND",
  "licence_source": "article",
  "licence_url": "https://creativecommons.org/licenses/by-nc-nd/4.0/",
  "metadata_licence": null,
  "native_subjects": [
    [
      "openalex",
      "2728|Traumatic Brain Injury and Neurovascular Disturbances"
    ]
  ],
  "openalex": "W7213967766",
  "pdf_url": "https://europepmc.org/articles/PMC13677420?pdf=render",
  "pmcid": "PMC13677420",
  "pmid": "42898170",
  "published": "2026-09-22",
  "publisher": null,
  "ris": "https://research.draconitic.com/paper/2tmszy7h77r5c.ris",
  "sources": [
    {
      "first_seen": "2026-10-30T12:19:41Z",
      "native_id": "MED:42898170",
      "source": "europepmc",
      "url": "https://europepmc.org/article/MED/42898170"
    }
  ],
  "subjects": [
    {
      "field": "medicine",
      "origin": "openalex:2728|Traumatic Brain Injury and Neurovascular Disturbances",
      "subfield": "neurology"
    }
  ],
  "title": "Penetrating brain injury from captive-bolt guns: A retrospective multicenter study of 77 cases.",
  "title_text": "Penetrating brain injury from captive-bolt guns: A retrospective multicenter study of 77 cases.",
  "type": "peer-reviewed",
  "updated_at": "2026-10-30T12:19:41Z",
  "url": "https://research.draconitic.com/paper/2tmszy7h77r5c",
  "venue": "Brain & spine",
  "versions": []
}