Management of head trauma due to landmine explosions: from battle field to operation room.

BACKGROUND: Head injuries due to landmine explosions are not well studied and the management of such injuries is not documented, even though there is, unfortunately, a regrettably high incidence of such injuries in the military and in civilians. METHODS: The data of 119 patients who underwent surgery for the head injuries due to landmine explosions were reviewed retrospectively. All of these patients were military personnel, and the mean age was 23 years. RESULTS: A total 83 (69.7%) of the cases were injured by the anti-personnel devices and 36 (30.3%) by vehicle landmines. Fifty percent of the patients underwent surgery for depressed skull fracture, intraparenchymal foreign body, epidural haematoma or subdural haematoma. Six (0.05%) patients died in the emergency room. CONCLUSION: Landmine explosions can produce classic injury patterns from blunt and penetrating mechanisms to several organ systems, including the brain. They also produce unique injury patterns to the brain. Understanding this important difference is critical in management of these injuries. Early surgical treatment and appropriate management could save more lives.

Is there any relationship between proinflammatory mediator levels in disc material and myelopathy with cervical disc herniation and spondylosis? A non-randomized, prospective clinical study.

The proinflammatory mediator (PIM) levels were assessed in surgically removed samples of herniated cervical intervertebral discs. The objective of this study was to investigate if there is a correlation between the levels of PIMs in disc material and myelopathy associated with cervical intervertebral disc herniation and spondylosis. The role of proinflammatory mediators in the degeneration of intervertebral disc and the inflammatory effects of disc herniations on radicular pain has been previously published. However, the possible relationship between PIMs and myelopathy related to cervical disc herniation and spondylosis has not been investigated before. Thirty-two patients undergoing surgery for cervical disc herniation and spondylosis were investigated. Surgically obtained disc materials, stored at 70 degrees C, were classified into two groups: cervical disc herniation alone or with myelopathy. Biochemical preparation and solid phase enzyme amplified sensitivity immunoassay (ELISIA) analysis of the samples were performed to assess the concentration of mediators in the samples. Very similar values of interleukin-6 were found in both groups whereas the concentrations of mediators were significantly higher in myelopathy group. This study has demonstrated that PIMs are involved in cervical intervertebral disc degeneration with higher concentrations in the samples associated with myelopathy.