| Summary: | 【Abstract】Objective: Terrorism-related bomb at-tacks on civilian population have increased dramatically over
the last decade. Craniocerebral injuries secondary to impro-vised explosive devices have not been widely reported in
the context of unarmored civilians. This series intends to
report the spectrum of these injuries secondary to suicidal
and implanted bombs as encountered at the Aga Khan Uni-versity Hospital, Pakistan (AKUH). Further, a few pertinent
management guidelines have also been discussed.
Methods: The hospital database and clinical coding
during a 5-year period were examined for head injuries se-condary to terrorism-associated blasts. In addition to pa-tient demographics, data analysis for our series included
initial Glasgow Coma Scale, presenting neurological
complaints, associated non-neurological injuries, manage-ment (conservative or operative) to associated
complications, and discharge neurological status.
Results: A total of 16 patients were included in this
series. Among them 9 were victims of suicidal blasts while 7
were exposed to implanted devices. The patients presented
with diverse patterns of injury secondary to a variety of
shrapnel. A follow-up record was available for 12 of the 16
patients (mean follow-up: 7.8 months), with most patients
having no active complaints.
Conclusion: The results of this series show that civi-lian victims of suicidal and improvised bombings present
with a wide range of neurological symptoms and injury
patterns, which often differ from the neurological injuries
incurred by military personnel in similar situations, and
thereby often require individualized care.
Key words: Brain injuries; Craniocerebral trauma;
Decompressive craniectomy
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