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.