A Clinical Analysis of Surgically Treated Head Injury on Military Personnel

ABSTRACT

During the three years from March, 1983 to Feb, 1986, 159 cases of head injury surgically treated in the department of neurosurgery, Capital Armed Forces General Hospital were clinicostatistically analysed and discussed with the review of the literature. The following results were obtained.1) Due to the army distinctiveness, all cases were male and the age incidence was becoming maximal at the third decade. 2) Traffic accidents form by far the largest Group(38.4%), and next are, in order of incidence, accidents due to fall from height, simple fall(19%), exercise(12.6%), gun shot wound or explosive injury(9.4%) and assault(9.4%). 3) Skull fracture were seen in 115 cases(72.3%), and nearly half of those 55 cases, were linear fracture. 4) Of the 133 patients with intracranial hematoma or subdural hygroma, 88 cases(66.7%) were accompanied by skull fracture. 93% of epidural hematomas were associated with skull fracture and the most common wite of hematoma was temporoparietal area. 5) Of all cases of subdural hematoma, acute type was prevalent(59.4%) and its main site involved was temporoparietal area. 6) The associated injuries were found in 22.6% of patients. The frequent ones were facial bone fracture, upper extremity fracture, clavicle fracture, and chest injury, in order. 7) The minor head injury of Glasgow coma scale score(GCS) of 13 to 15 was 68 cases(42.8%). The moderated head injury of 9 to 12 was 28 cases(17.6) and the serve head injury of 3 to 8, 63 cases(39.1%). 8) The operation mortality was 26.8% and the good recovery was achieved 55.4% of patients. The remaining 18.8% resulted in disabled or vegetative state. 9) In the accidents of gun shot wound or explosive injury, operation mortality rate was 60%, but 5 cases(33.3%) were seen good recovery.