Introduction: military neurosurgery, past and present. 2010

Paul Klimo, and Brian T Ragel
88th Medical Group, Wright-Patterson Air Force Base, Ohio, USA.

For a physician has the worth of many other warriors, both for the excision of arrows and for the administration of soothing drugs. Homer, Iliad XI.514-515 Ever since armed conflict has been used as a means to settle disputes among men, there have been those who have been tasked to mend the wounds that ravage a soldier's body from the weapons of war. The Iliad portrays the pivotal 10th year of the legendary Trojan War, during which a schism in the Greek leadership prolongs the extended siege of the city of Troy. In the midst of this martial epic come the lines quoted above, quietly attesting to the value of the military physician, even under the crude conditions of the Greek Dark Age. They are uttered by Idomeneus, one of the foremost Greeks, when he is enjoining one of his comrades, Nestor, to rescue the injured Greek physician Machaon and take him back from the line to treat his wounds. He is afraid that Machaon will be captured by the Trojans, a loss far greater than that of any other single warrior. Duty to country has helped shape the careers of many neurosurgeons, including iconic US figures such as Harvey Cushing and Donald Matson. This issue of Neurosurgical Focus celebrates the rich history of military neurosurgery from the wars of yesterday to the conflicts of today. We have been humbled by the tremendous response to this topic. The 25 articles within this issue will provide the reader with both a broad and an in-depth look at the many facets of military neurosurgery. We have attempted to group articles based on their predominant topic. We also encourage our audience to read other recently published articles. The first 8 articles relate to the current conflicts in Afghanistan and Iraq. The lead article, written by Randy Bell and colleagues from the National Naval Medical Center and Walter Reed Army Medical Center, discusses what is arguably one of the most important contributions by military neurosurgeons from these 2 conflicts: the rapid and aggressive use of decompressive craniectomies. This is followed by articles on decompressive craniectomy techniques by Ragel and colleagues and cranioplasty outcomes by Stephens and colleagues. After reading these articles, the reader will come away with an appreciation of the often complex nature of wartime penetrating and closed-head injuries and the remarkable recovery that many injured soldiers make with time.

UI MeSH Term Description Entries
D007493 Iraq A country bordering the Persian Gulf, between Iran and Kuwait. The capital is Baghdad. Republic of Iraq
D008297 Male Males
D008887 Military Medicine The practice of medicine as applied to special circumstances associated with military operations. Medicine, Military
D009493 Neurosurgery A surgical specialty concerned with the treatment of diseases and disorders of the brain, spinal cord, and peripheral and sympathetic nervous system. Neurosurgeries
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D000346 Afghanistan Country located north and west of Pakistan, and east of Iran. The capital is Kabul.
D014481 United States A country in NORTH AMERICA between CANADA and MEXICO.
D014857 Warfare Methods of conducting ARMED CONFLICTS.
D049674 History, 21st Century Time period from 2001 through 2100 of the common era. 21st Century History,21st Cent. History (Medicine),21st Cent. History of Medicine,21st Cent. Medicine,Historical Events, 21st Century,History of Medicine, 21st Cent.,History, Twenty-first Century,Medical History, 21st Cent.,Medicine, 21st Cent.,21st Cent. Histories (Medicine),21st Cent. Medicines,21st Century Histories,Cent. Histories, 21st (Medicine),Cent. History, 21st (Medicine),Cent. Medicine, 21st,Cent. Medicines, 21st,Century Histories, 21st,Century Histories, Twenty-first,Century History, 21st,Century History, Twenty-first,Histories, 21st Cent. (Medicine),Histories, 21st Century,Histories, Twenty-first Century,History, 21st Cent. (Medicine),History, Twenty first Century,Medicines, 21st Cent.,Twenty-first Century Histories,Twenty-first Century History
D019635 Neurosurgical Procedures Surgery performed on the nervous system or its parts. Procedures, Neurosurgical,Surgical Procedures, Neurologic,Neurologic Surgical Procedure,Neurologic Surgical Procedures,Neurosurgical Procedure,Procedure, Neurologic Surgical,Procedure, Neurosurgical,Procedures, Neurologic Surgical,Surgical Procedure, Neurologic

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