Operative treatment of paediatric penetrating head injuries in southern Afghanistan

Abstract

The operative management and early post-operative outcome of 16 consecutive cases of paediatric penetrating head injury treated by a single surgeon at a military trauma centre in Southern Afghanistan are retrospectively analysed. The majority of cases of injury were caused by fragments from exploding munitions. The aim of neurosurgical intervention in penetrating head injury is the prevention of wound infection and treatment or prevention of a critical rise in intracranial pressure. In 14 cases in this study, these aims were fulfilled without resort to brain resection, although a delayed cranioplasty procedure was required in 6 patients. Despite the ongoing conflict, families, local communities and coalition forces transport teams combine to make the latter a viable option in Southern Afghanistan, with an excellent short-term outcome.

Keywords::

• craniectomy
• cranioplasty
• surgery
• trauma

Acknowledgements

All per-operative photographs were taken by CDR Charles Hodges, Chaplain Corps, United States Navy.

Declaration of interest: The authors report no declarations of interest. The authors alone are responsible for the content and writing of the paper.

All authors have been deployed at Kandahar Airfield MMU, Dr Gibbons being present at the same time as the main authors’ initial deployment. Dr Gibbons made a substantial contribution to the concept and design of this study, whilst both Drs Christie and Eisenberg were responsible for a considerable amount of input in the later stages of writing the discussion section of the paper.