Early decompressive craniectomy for blast and penetrating brain injury in war: Lessons for civilian surgeons

Jeffrey V. Rosenfeld, Randy S. Bell, Rocco Armonda

Research output: Chapter in Book/Report/Conference proceedingChapter (Book)Researchpeer-review


Bomb blast causes severe multiple trauma and distinctive patterns of head and neck injury. Brain swelling, hemorrhage, and penetrating metal and bone fragments with intracranial air are typical, resulting in severe intracranial hypertension. Decompressive craniectomy has become a mainstay of treatment for blast and missile penetrating injuries of the brain occurring in modern warfare. The clinical management and the surgical techniques for these injuries are directly transferable to the management of civilians injured by bomb blast during terrorist attacks in countries where wars are not being fought. We therefore strongly recommend that civilian neurosurgeons become familiar with the resuscitation, assessment, investigation, and surgery required to treat these injuries.

Original languageEnglish
Title of host publicationDecompressive Craniectomy
EditorsBizhan Aarabi, J. Marc Simard
Place of PublicationNew York NY USA
PublisherNova Science Publishers
Number of pages25
ISBN (Electronic)9781536131819
ISBN (Print)9781536131802
Publication statusPublished - Mar 2018


  • Blast injury
  • Decompressive craniectomy
  • Gunshot wound
  • Military surgery
  • Penetrating brain injury

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