Management of Ballistic Trauma to the Head

Neal, Chris J.; Ling, Geoffrey; Ecklund, James M.

doi:10.1007/1-84628-060-5_15

Cited by 2 publications

(1 citation statement)

References 48 publications

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“…The microbiology of modern war wounds is unique to each military conflict depending on the climatic and geographical features of the theater of combat 3,4 . The mechanism of high velocity weapons injury predisposes to development of intracranial infection, mostly due to the cavitation effect, causing initial expansion in brain tissue (often 10 to 20 times the size of the projectile), which collapses under negative pressure that may draw in external debris 27 . Patients with severe head injuries are also prone to infection as they have prolonged intubation, decreased respiratory function, prolonged immobilization, and posttraumatic immunosuppression.…”

Section: Introductionmentioning

confidence: 99%

Risk factors for postoperative infection after combat related head injuries

Pavlićević¹

2022

Serb J Neurosurg

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Introduction The prevalence of penetrating head injuries (PBI) has increased during the latest wars making up to 37,4% of all injuries (1,2) Microbiology of modern war wounds is unique for each military conflict depending on the climatic and geographical features of the theater of combat (3,4). Material and methods: 286 patients were operatively treated after penetrating combat injury in our institution between 1991-1999. Based on the inclusion criteria: combat-related cranial injury and absence of severe abdominal or chest combat injuries, as well as their ability to report for a follow-up exam led to the inclusion of 202 patients. Initial surgical treatment included removal of devitalized soft tissue and bone fragments with craniectomy, removal of devitalized brain tissue, easily accessible intracerebral bone and metal fragments and intracranial hemathoma. All patients received the same standardized postoperative care with triple antibiotics. Results Infection occurred in 36 patients (17,82%). In vast majority of the cases infection occurred in the form of brain abscess 31 (86.11%), in 4 cases as meningitis (11.1%) and in 1 case as osteomyelitis and epidural infection (2.78%). Retained metal and bone fragments and postoperative liquorrhea have significant influences on occurrence of postoperative infection. Conclusion Postoperative infection considerably increases long term functional outcome. Using advantages of minimally invasive surgical technique, neuronavigation or intraoperative imaging for removal of retained foreign bodies can reduce risk for postoperative infection with minimal risk of additional neurologic deficit. Autograft is preferable option for dural reconstruction in combat related head injuries.

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Section: Introductionmentioning

confidence: 99%

Risk factors for postoperative infection after combat related head injuries

Pavlićević¹

2022

Serb J Neurosurg

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Phineas P Gage - ‘The man with the Iron bar’

Grieve

2010

Trauma

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Phineas P Gage was a railway construction workman who, in 1848, received a devastating penetrating head injury. A 4 ft long tamping iron was fired by accident through his skull destroying both frontal lobes. He survived the accident through luck, the care he received from colleagues at the scene and through medical care received from doctors. This article examines closely the injury pattern, prehospital care, trauma care and medical and psychiatric sequelae Gage received.

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Management of Ballistic Trauma to the Head

Cited by 2 publications

References 48 publications

Risk factors for postoperative infection after combat related head injuries

Risk factors for postoperative infection after combat related head injuries

Phineas P Gage - ‘The man with the Iron bar’

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