[Primary neurosurgical treatment of craniocerebral war injuries]

From September 1991 to December 1992, 41 patients with nonpenetrating and 84 patients with penetrating craniocerebral injuries were neurosurgically treated at the Military Medical Academy. The severity of injuries was estimated according to GCS and the outcome according to GOS. In 17 out of 27 patients with moderate nonpenetrating CCI, the outcome was favorable, and 5 patients out of 7 with severe CCI died (p < 0.01). Out of 33 patients with moderate penetrating CCI, favorable outcome or moderate disability were observed in 21 patients, and out of 26 patients with severe CCI, 19 died (p < 0.01). The majority of unilobar CCI resulted in favorable outcome or moderate disability, while 10 out of 26 patients with multilobar CCI, as well as 9 out of 16 patients with bichemispheric CCI died (p < 0.01). Mortality rate in patients with penetrating CCI was 25%. No significant differences were observed in the outcome of penetrating CCI in relation to the missile type (p > 0.05). Nonpenetrating CCI had a better outcome than the penetrating ones (p < 0.05). The outcome of war nonpenetrating CCI depended on the severity of injury and of penetrating CCI on the severity injury, of the extent of cerebral lesion and the form of penetration, respectively.