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Citation |
Ashworth E, Baxter D, Gibb I, Wilson M, Bull A. J. Neurotrauma 2024; ePub(ePub): ePub. |
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Copyright |
(Copyright © 2024, Mary Ann Liebert Publishers) |
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DOI |
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PMID |
38613818 |
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Abstract |
Blast is the most common injury mechanism in conflicts of this century due to the widespread use of explosives, confirmed by recent conflicts such as in Ukraine. Data from conflicts in the last century such as Northern Ireland, the Falklands and Vietnam up to present day, show between 16 and 21% of personnel suffered a traumatic brain injury. Typical features of fatal brain injury to those outside of a vehicle (hereafter referred to as dismounted) due to blast include the presence of haemorrhagic brain injury alongside skull fractures rather than isolated penetrating injuries more typical of traditional ballistic head injuries. The heterogeneity of dismounted blast has meant that analysis from databases is limited and therefore a detailed look at the radiological aspects of injury is needed to understand the mechanism and pathology of dismounted blast brain injury. The aim of this study was to identify the head and spinal injuries in fatalities due to dismounted blast. All UK military fatalities from dismounted blast who suffered a head injury from 2007-2013 in the Iraq and Afghanistan conflicts were identified retrospectively. Post-mortem computerised tomography images (CTPMs) were interrogated for injuries to the head, neck and spine. All injuries were documented and classified using a radiology brain injury classification tool. Chi-squared and Fisher's Exact tests were used investigate correlations between injuries, along with odds ratios for determining direction of correlation. The correlations were clustered. There were 71 fatalities from dismounted blast with an associated head injury with a CTPM or initial CT available for analysis. The results showed the heterogeneity of injury from dismounted blast but also some potential identifiable injury constellations. These were: • intracranial haemorrhage • deep haemorrhage • spinal injury • facial injury These identified injury patterns can now be investigated to consider injury mechanisms and so develop mitigation strategies or clinical treatments. Language: en |
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Keywords |
ADULT BRAIN INJURY; CT SCANNING; MILITARY INJURY; Penetrating Ballistic-like Brain Injury; RADIOLOGY |