Abstract | OBJECT: METHODS: Neurosurgical operative logs from service (October 2007 to September 2009) in Afghanistan that detail DC cases for trauma were analyzed. Illustrative examples of frontotemporoparietal and bifrontal DC that depict battlefield experience performing these procedures are presented with attention drawn to the L.G. Kempe hemispherectomy incision, brainstem decompression techniques, and dural onlay substitutes. RESULTS: CONCLUSIONS: Thirty-one percent of craniotomies performed for trauma were DCs. Battlefield neurosurgeons use DC to allow for safe transfer of neurologically ill patients to tertiary military hospitals, which can be located 8-18 hours from a war zone. The authors recommend the L.G. Kempe incision for blood supply preservation, large craniectomies to prevent brain strangulation over bone edges, minimal brain debridement, adequate brainstem decompression, and dural onlay substitutes for dural closure.
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Authors | Brian T Ragel, Paul Klimo Jr, Jonathan E Martin, Richard J Teff, Hans E Bakken, Rocco A Armonda |
Journal | Neurosurgical focus
(Neurosurg Focus)
Vol. 28
Issue 5
Pg. E2
(May 2010)
ISSN: 1092-0684 [Electronic] United States |
PMID | 20568936
(Publication Type: Comparative Study, Journal Article)
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Topics |
- Adolescent
- Adult
- Afghan Campaign 2001-
- Afghanistan
- Brain Injuries
(surgery)
- Child, Preschool
- Decompressive Craniectomy
(methods)
- Dura Mater
(surgery)
- General Surgery
(methods)
- Hemispherectomy
(methods)
- Humans
- Intracranial Hypertension
(surgery)
- Military Medicine
(methods)
- Neurosurgical Procedures
(methods)
- Surgical Flaps
- Treatment Outcome
- Warfare
- Wounds, Gunshot
(surgery)
- Wounds, Penetrating
(surgery)
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