ORBITOCRANIAL WAR INJURIES - REPORT OF 14 CASES

Objective: In this study, we review the initial clinical and radiologi cal management and early outcomes of 14 patients with orbitocranial wa r injuries treated at the University Hospital Split between 1991 and 1 995. Methods: This investigation involves 14 patients (13 soldiers and 1 civilian) with orbitocranial war injuries. The mean patient age was 31 years (range, 23-54 years), The penetrating object was a metal shr apnel fragment in 8 patients and a bullet in 6 patients, The results o f clinical and radiological management were retrospectively analyzed. Results: The mean time from the moment of wounding to hospital admissi on was 6 hours (range, 1-30 hours). The mean Glasgow Coma Scale score was 8 (range, 3-14), Craniotomy was the basic neurosurgical procedure, and three patients were treated with simple scalp wound debridement a nd closure. Osteoplastic operations of the orbital bones were performe d in 13 patients. Enucleation/evisceration was performed in 6 patients (42.8%), At discharge, the mean Glasgow Outcome Scale score was 13, a nd 1 patient died in the hospital. Blindness (including amaurosis and anophthalmus) was present in nine eyes (8 patients), light-perception positivity and projection positivity were present in four eyes, and vi sual acuity was at 0.1 in 1 patient. Conclusion: An early multidiscipl inary therapeutic approach and computed tomography as a diagnostic pro cedure are necessary for a good result in the treatment of orbitocrani al war injuries.