Single neurosurgeon operative experience at craig joint theater hospital during the Afghanistan surge (November 2010 to April 2011), Part II: Humanitarian cases

Abstract

Background: The Afghanistan Surge saw NATO troops working with their Afghan partners to remove Taliban governance and replace it with a more democratic model. As part of this endeavor, medical support for both trauma and humanitarian cases was needed. Objective: Identify and discuss disease trends to better prepare for future combat medical treatments. Methods: Retrospective review of operative experience from a neurosurgeon from November 2010 to April 2011. Results: 63 cases were performed on 20 NATO and 43 Afghan patients. Combatrelated neurotrauma represented 73% (46/63) of cases and humanitarian cases represented the remainder. The most common diseases among humanitarian cases were benign tumors (29%, 5/17), cranioplasty (23%, 4/17), obstructive hydrocephalus (11%, 2/17), nonobstructive hydrocephalus (11%, 2/17), hemifacial spasm (11%, 2/17), and cerebral angiography (11%, 2/17). There was 1 death from ventriculitis for a complication rate of 6%. Conclusion: In select well-nourished, patients with minimal risk of needing tracheostomy, humanitarian neurosurgery can be safely performed in theater with a complication rate (6%) no worse than patients operated on in the United States.