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Successful management of a severe combat penetrating brain injury
  1. Clément Hoffmann1,
  2. E Falzone1,
  3. A Dagain2,
  4. A Cirodde3,
  5. T Leclerc3 and
  6. B Lenoir1
  1. 1Department of Anesthesiology and Intensive Care Medicine, Percy Military Teaching Hospital, Clamart, France
  2. 2Department of Neurosurgery, Sainte Anne Military Teaching Hospital, Toulon, France
  3. 3Burns Treatment Center, Percy Military Teaching Hospital, Clamart, France
  1. Correspondence to Dr Clément Hoffmann, Department of Anesthesiology and Intensive Care Medicine, Hôpital d'Instruction des Armées Percy, 101, avenue Henri Barbusse, BP 406, Clamart, Cedex 92141, France; clement.hoffmann{at}


We report the case of successful management of a transcranial penetrating high-energy transfer injury in a 20-year-old soldier. The bullet traversed both cerebral hemispheres and lacerated the superior sagittal sinus rendering him unconscious. We detail the care received at all stages following injury from ‘Buddy Aid’ on the battlefield, resuscitation by a forward medical team through to prompt neurosurgery within 2 h of injury. Subsequent aeromedical evacuation and continuing aggressive critical care has allowed the patient to survive with acceptable neurological impairment after what is generally considered an unsurvivable injury.

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