Penetrating craniocerebral shrapnel injuries during 'Operation Desert Storm': early results of a conservative surgical treatment
| Autor: | George R. Cybulski, Abdur R. Choudhury, Kamal Chaudhri, K. R. Al Moutaery |
|---|---|
| Rok vydání: | 1994 |
| Předmět: |
medicine.medical_specialty
Warfare Critical Care medicine.medical_treatment Middle East Postoperative Complications medicine Humans Glasgow Coma Scale Abscess Craniotomy Cerebral Cortex Neurologic Examination Debridement integumentary system medicine.diagnostic_test business.industry Head injury Brain Interventional radiology medicine.disease Foreign Bodies Surgery medicine.anatomical_structure Military Personnel Scalp Brain Injuries Wounds Gunshot Neurology (clinical) Neurosurgery business Tomography X-Ray Computed Follow-Up Studies |
| Zdroj: | Acta neurochirurgica. 126(2-4) |
| ISSN: | 0001-6268 |
| Popis: | A follow-up study is presented of the initial neurosurgical treatment of 20 patients who sustained penetrating craniocerebral injuries during "Operation Desert Storm". Fifteen of these patients had received intracranial debridement through a craniectomy and five patients had received care of scalp wounds only. Following treatment and stabilisation in a frontline hospital, these patients were transferred to the Riyadh Armed Forces Hospital for further evaluation and management. On admission, all the patients received a computerised tomographic scan which revealed shrapnel fragments inside their brain. No attempt had been made to remove the metal fragments. A patient with an infected scalp wound was treated with a course of appropriate antibiotics and the wound dressed. Dexamethasone was not used. Anticonvulsants were used only in one patient who had been treated for a presumed cerebral abscess. The neurological status of the patients improved along with the reduction of oedema and the swelling of the brain as shown in the follow-up CT scans. No patient died or developed a seizure disorder. These results suggest that re-operation for removal of retained fragments is unnecessary. It is concluded that the initial treatment of shrapnel wounds of the brain should be to preserve maximal cerebral tissue and function either by limiting the wound debridement performed through a craniectomy or by care of scalp wounds only. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|
Full text from SpringerLink