Bashir Muhammad-Umair, Tahir Muhammad-Zubair, Bari Ehsan, Mumtaz Sehreen
Department of Neurosurgery, Aga Khan University Hospital, Karachi, Pakistan.
Chin J Traumatol. 2013;16(3):149-57.
Terrorism-related bomb attacks on civilian population have increased dramatically over the last decade. Craniocerebral injuries secondary to improvised 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 University Hospital, Pakistan (AKUH). Further, a few pertinent management guidelines have also been discussed.
The hospital database and clinical coding during a 5-year period were examined for head injuries secondary to terrorism-associated blasts. In addition to patient demographics, data analysis for our series included initial Glasgow Coma Scale, presenting neurological complaints, associated non-neurological injuries, management (conservative or operative) to associated complications, and discharge neurological status.
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.
The results of this series show that civilian 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.
在过去十年中，针对平民的与恐怖主义相关的炸弹袭击急剧增加。在未穿戴防护装备的平民中，简易爆炸装置导致的颅脑损伤尚未得到广泛报道。本系列旨在报告在巴基斯坦阿迦汗大学医院（AKUH）所遇到的自杀式炸弹和植入式炸弹造成的此类损伤情况。此外，还讨论了一些相关的管理指南。
对医院数据库和5年期间的临床编码进行检查，以查找与恐怖主义相关爆炸导致的头部损伤。除患者人口统计学资料外，本系列的数据分析还包括初始格拉斯哥昏迷量表、出现的神经学症状、相关的非神经学损伤、针对相关并发症的处理（保守或手术）以及出院时的神经学状况。
本系列共纳入16例患者。其中9例为自杀式爆炸受害者，7例接触了植入式装置。患者因各种弹片呈现出不同的损伤模式。16例患者中有12例有随访记录（平均随访时间：7.8个月），大多数患者无明显不适。
本系列结果表明，自杀式和简易爆炸袭击的平民受害者表现出广泛的神经学症状和损伤模式，这些症状和模式往往与军事人员在类似情况下所遭受的神经学损伤不同，因此通常需要个体化护理。
