MANAGEMENT OF WAR PENETRATING CRANIOCEREBRAL INJURIES DURING THE WAR IN CROATIA

From September 1991 to December 1992, during the war in Croatia, the G eneral Hospital in Slavonski Brod served as an evacuation centre. Duri ng that period 197 patients with war-related penetrating craniocerebra l injuries were admitted. They were analyzed according to wound charac teristics, operability, mortality, operative and post-operative compli cations, and their condition after hospital discharge and follow-up. A less aggressive surgical approach was accepted in our surgical strate gy, recommended in recent studies, followed by an aggressive intensive management. All patients received antibiotics (''war scheme'') and an ticonvulsants. Early results of treatment do not differ significantly from other recent studies (Vietnam, Israel) in respect to both mortali ty and complications. Follow-up was difficult. Most of the patients we re Bosnia and Herzegovina citizens who were refugees and banished to f oreign countries; thus their addresses were unknown. They are conseque ntly lost to follow-up. A less aggressive surgical approach proved to be justified. Routine use of antibiotics and anticonvulsants lowered t he infection rate and early seizure incidence to an acceptable level. Late seizure incidence is similar to those previously reported. (C) 19 98 Published by Elsevier Science Ltd. All rights reserved.