The management of acute craniocerebral injuries caused by missiles: analysis of 110 consecutive penetrating wounds of the brain from Basrah.

Penetrating missile injuries of the head comprised 3.4 per cent of the missile injuries admitted to our hospital directly or transferred from nearby hospitals. Those who died accounted for approximately 70 per cent of the total deaths in hospital from missiles. The immediate treatment is presented and the results are evaluated in 110 consecutive cases. The points emphasized are, first, that less than rapid evacuation selects those patients who are probably going to survive anyway; second, that bullet wounds of the head are nearly always fatal, especially if inflicted by high-velocity weapons; and, third, that the operation should include wide exposure of the injured site with thorough excision of the wound track and watertight closure of the dura.