{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,13]],"date-time":"2026-04-13T16:08:09Z","timestamp":1776096489989,"version":"3.50.1"},"reference-count":84,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","issue":"1","license":[{"start":{"date-parts":[[2026,1,5]],"date-time":"2026-01-05T00:00:00Z","timestamp":1767571200000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["J Neurosurg Case Lessons"],"published-print":{"date-parts":[[2026,1,5]]},"abstract":"<jats:sec>\n                    <jats:title>BACKGROUND<\/jats:title>\n                    <jats:p>Posterior fossa penetrating traumatic brain injury (pTBI) in military combat is rare but carries high neurovascular risk.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>OBSERVATIONS<\/jats:title>\n                    <jats:p>A 51-year-old male sustained a mine explosion injury in Ukraine, in which a 4 \u00d7 1.5\u2013cm metal fragment penetrated through the skull base into the posterior cranial fossa. The fragment was adjacent to the vertebral artery, sigmoid sinus, lower cranial nerves, and occipital condyle. Digital subtraction angiography was completed on arrival, which showed a patent right vertebral artery, occluded transverse-sigmoid sinus, and partial internal jugular vein occlusion. The patient underwent a right retrosigmoid craniotomy for foreign body removal and debridement. CSF release from the cerebellomedullary cisterns facilitated visualization while reducing retraction injury risk. The fragment was removed atraumatically and a vascularized pericranial graft was used for closure.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>LESSONS<\/jats:title>\n                    <jats:p>Military posterior fossa pTBI presents unique challenges related to blast mechanisms. Effective management requires early angiography for suspicion of vascular injury and meticulous microsurgical technique, even in resource-constrained environments where a one-stage, comprehensive approach to treatment may be valuable.<\/jats:p>\n                    <jats:p>\n                      <jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" ext-link-type=\"uri\" xlink:href=\"https:\/\/thejns.org\/doi\/10.3171\/CASE25563\">https:\/\/thejns.org\/doi\/10.3171\/CASE25563<\/jats:ext-link>\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.3171\/case25563","type":"journal-article","created":{"date-parts":[[2026,1,22]],"date-time":"2026-01-22T12:00:00Z","timestamp":1769083200000},"source":"Crossref","is-referenced-by-count":0,"title":["Posterior fossa penetrating traumatic brain injury from military blast: illustrative case"],"prefix":"10.3171","volume":"11","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7125-8303","authenticated-orcid":true,"given":"Jeffrey M.","family":"Breton","sequence":"first","affiliation":[{"name":"Department of Neurosurgery, MedStar Georgetown University Hospital, Washington, DC"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0006-4955-7696","authenticated-orcid":true,"given":"Stefan T.","family":"Prvulovic","sequence":"additional","affiliation":[{"name":"Georgetown University School of Medicine, Washington, DC"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Cameron J.","family":"Sabet","sequence":"additional","affiliation":[{"name":"Georgetown University School of Medicine, Washington, DC"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Bohdan","family":"Sirko","sequence":"additional","affiliation":[{"name":"Center for Cerebral Neurosurgery, Mechnikov Dnipropetrovsk Regional Clinical Hospital, Dnipro, Ukraine"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9494-1594","authenticated-orcid":true,"given":"Rostyslav","family":"Malyi","sequence":"additional","affiliation":[{"name":"Center for Cerebral Neurosurgery, Mechnikov Dnipropetrovsk Regional Clinical Hospital, Dnipro, Ukraine"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9336-5639","authenticated-orcid":true,"given":"Vadym","family":"Perepelytsia","sequence":"additional","affiliation":[{"name":"Endovascular Center, Mechnikov Dnipropetrovsk Regional Clinical Hospital, Dnipro, Ukraine"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rocco A.","family":"Armonda","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, MedStar Georgetown University Hospital, Washington, DC"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6536-2035","authenticated-orcid":true,"given":"Andrii","family":"Sirko","sequence":"additional","affiliation":[{"name":"Center for Cerebral Neurosurgery, Mechnikov Dnipropetrovsk Regional Clinical Hospital, Dnipro, Ukraine"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1754","reference":[{"issue":"5","key":"bib1","series-title":"Neurosurgery","first-page":"696","article-title":"Civilian gunshot wounds to the head: a prospective study","volume":"27","author":"Grahm","year":"1990","unstructured":"Grahm TWWilliams FCHarrington TSpetzler RF.Civilian gunshot wounds to the head: a prospective study. Neurosurgery. 1990;27(5):696-700."},{"issue":"3-4","key":"bib2","series-title":"Acta Neurochir (Wien)","first-page":"133","article-title":"Gunshot wounds of the brain in civilians","volume":"94","author":"Cavaliere","year":"1988","unstructured":"Cavaliere RCavenago LSiccardi DViale GL.Gunshot wounds of the brain in civilians. Acta Neurochir (Wien). 1988;94(3-4):133-136."},{"issue":"6","key":"bib3","series-title":"Surg Neurol","first-page":"455","article-title":"Penetrating craniocerebral missile injuries in civilians: a retrospective analysis of 314 cases","volume":"35","author":"Siccardi","year":"1991","unstructured":"Siccardi DCavaliere RPau ALubinu FTurtas SViale GL.Penetrating craniocerebral missile injuries in civilians: a retrospective analysis of 314 cases. Surg Neurol. 1991;35(6):455-460."},{"issue":"1","key":"bib4","series-title":"J Neurosurg","first-page":"9","article-title":"Analysis of 76 civilian craniocerebral gunshot wounds","volume":"65","author":"Clark","year":"1986","unstructured":"Clark WCMuhlbauer MSWatridge CBRay MW.Analysis of 76 civilian craniocerebral gunshot wounds. J Neurosurg. 1986;65(1):9-14."},{"issue":"3","key":"bib5","series-title":"J Neurosurg","first-page":"645","article-title":"Predictors of outcome in civilians with gunshot wounds to the head upon presentation","volume":"121","author":"Gressot","year":"2014","unstructured":"Gressot LVChamoun RBPatel AJPredictors of outcome in civilians with gunshot wounds to the head upon presentation. J Neurosurg. 2014;121(3):645-652."},{"issue":"1","key":"bib6","series-title":"Neurosurg Focus","first-page":"e2","article-title":"Outcome prediction following penetrating craniocerebral injury in a civilian population: aggressive surgical management in patients with admission Glasgow Coma Scale scores of 6 to 15","volume":"8","author":"Levy","year":"2000","unstructured":"Levy ML.Outcome prediction following penetrating craniocerebral injury in a civilian population: aggressive surgical management in patients with admission Glasgow Coma Scale scores of 6 to 15. Neurosurg Focus. 2000;8(1):e2."},{"issue":"4","key":"bib7","series-title":"Neurosurg Clin N Am","first-page":"701","article-title":"Patients with Glasgow Coma Scale scores 3, 4, 5 after gunshot wounds to the brain","volume":"6","author":"Kaufman","year":"1995","unstructured":"Kaufman HHLevy MLStone JLPatients with Glasgow Coma Scale scores 3, 4, 5 after gunshot wounds to the brain. Neurosurg Clin N Am. 1995;6(4):701-714."},{"issue":"5","key":"bib8","series-title":"Neurosurgery","first-page":"533","article-title":"Civilian gunshot wounds to the brain: prognosis and management","volume":"18","author":"Nagib","year":"1986","unstructured":"Nagib MGRockswold GLSherman RSLagaard MW.Civilian gunshot wounds to the brain: prognosis and management. Neurosurgery. 1986;18(5):533-537."},{"issue":"2","key":"bib9","series-title":"Surg Neurol","first-page":"98","article-title":"Prognostic factors and treatment of penetrating gunshot wounds to the head","volume":"60","author":"Martins","year":"2003","unstructured":"Martins RSSiqueira MGSantos MTSZanon-Collange NMoraes OJS.Prognostic factors and treatment of penetrating gunshot wounds to the head. Surg Neurol. 2003;60(2):98-104."},{"issue":"12","key":"bib10","series-title":"Am Surg","first-page":"1009","article-title":"Civilian craniocerebral gunshot wounds: an update in predicting outcomes","volume":"71","author":"Murano","year":"2005","unstructured":"Murano TMohr AMLavery RFLynch CHomnick ATLivingston DH.Civilian craniocerebral gunshot wounds: an update in predicting outcomes. Am Surg. 2005;71(12):1009-1014."},{"issue":"4","key":"bib11","series-title":"Neurosurg Rev","first-page":"231","article-title":"Analysis of 107 civilian craniocerebral gunshot wounds","volume":"25","author":"Ozkan","year":"2002","unstructured":"Ozkan UKemalo\u011flu SOzate\u015f MAydin MD.Analysis of 107 civilian craniocerebral gunshot wounds. Neurosurg Rev. 2002;25(4):231-236."},{"issue":"1-2","key":"bib12","series-title":"Acta Neurochir (Wien)","first-page":"27","article-title":"The early prognosis of craniocerebral gunshot wounds in civilian practice as an aid to the choice of treatment. A series of 56 cases studied by the computerized tomography","volume":"74","author":"Shoung","year":"1985","unstructured":"Shoung HMSichez JPPertuiset B.The early prognosis of craniocerebral gunshot wounds in civilian practice as an aid to the choice of treatment. A series of 56 cases studied by the computerized tomography. Acta Neurochir (Wien). 1985;74(1-2):27-30."},{"issue":"6","key":"bib13","series-title":"Neurosurgery","first-page":"689","article-title":"Gunshot wounds to the head: a perspective","volume":"18","author":"Kaufman","year":"1986","unstructured":"Kaufman HHMakela MELee KFHaid RWGildenberg PL.Gunshot wounds to the head: a perspective. Neurosurgery. 1986;18(6):689-695."},{"issue":"1","key":"bib14","series-title":"Neurosurgery","first-page":"77","article-title":"Outcome prediction after penetrating craniocerebral injury in a civilian population: aggressive surgical management in patients with admission Glasgow Coma Scale scores of 3, 4, or 5","volume":"35","author":"Levy","year":"1994","unstructured":"Levy MLMasri LSLavine SApuzzo ML.Outcome prediction after penetrating craniocerebral injury in a civilian population: aggressive surgical management in patients with admission Glasgow Coma Scale scores of 3, 4, or 5. Neurosurgery. 1994;35(1):77-85."},{"issue":"4","key":"bib15","series-title":"Neurosurg Clin N Am","first-page":"689","article-title":"Multivariate analysis and prediction of outcome following penetrating head injury","volume":"6","author":"Polin","year":"1995","unstructured":"Polin RSShaffrey MEPhillips CDGermanson TJane JA.Multivariate analysis and prediction of outcome following penetrating head injury. Neurosurg Clin N Am. 1995;6(4):689-699."},{"issue":"5-6","key":"bib16","series-title":"Mil Med","first-page":"e774","article-title":"Mortality and functional outcome predictors in combat-related penetrating brain injury treatment in a specialty civilian medical facility","volume":"185","author":"Sirko","year":"2020","unstructured":"Sirko APilipenko GRomanukha DSkrypnik A.Mortality and functional outcome predictors in combat-related penetrating brain injury treatment in a specialty civilian medical facility. Mil Med. 2020;185(5-6):e774-e780."},{"issue":"4","key":"bib17","series-title":"Neurosurg Clin N Am","first-page":"715","article-title":"Penetrating injuries in the Vietnam War. Traumatic unconsciousness, epilepsy, and psychosocial outcome","volume":"6","author":"Salazar","year":"1995","unstructured":"Salazar AMSchwab KGrafman JH.Penetrating injuries in the Vietnam War. Traumatic unconsciousness, epilepsy, and psychosocial outcome. Neurosurg Clin N Am. 1995;6(4):715-726."},{"issue":"5","key":"bib18","series-title":"Neurosurgery","first-page":"692","article-title":"Surgical outcome in 435 patients who sustained missile head wounds during the Iran\u2013Iraq War","volume":"27","author":"Aarabi","year":"1990","unstructured":"Aarabi B.Surgical outcome in 435 patients who sustained missile head wounds during the Iran\u2013Iraq War. Neurosurgery. 1990;27(5):692-695."},{"issue":"1","key":"bib19","series-title":"J Surg Emerg Med","article-title":"Blast scaling parameters: transitioning from lung to skull base metrics","volume":"1","author":"Lucke-Wold","year":"2017","unstructured":"Lucke-Wold BPTurner RCLogsdon AFRosen CLQaiser R.Blast scaling parameters: transitioning from lung to skull base metrics. J Surg Emerg Med. 2017;1(1):3."},{"issue":"3-4","key":"bib20","series-title":"Surg Neurol","first-page":"225","article-title":"Civilian infratentorial gunshot injuries: outcome analysis of 26 patients","volume":"58","author":"Nathoo","year":"2002","unstructured":"Nathoo NChite SHEdwards PJvan Dellen JR.Civilian infratentorial gunshot injuries: outcome analysis of 26 patients. Surg Neurol. 2002;58(3-4):225-233."},{"issue":"2","key":"bib21","series-title":"J Neurosurg","first-page":"443","article-title":"Surgical treatment of penetrating wounds after resuscitation study: a new classification system for penetrating injuries to the posterior fossa","volume":"143","author":"Sirko","year":"2025","unstructured":"Sirko ATraylor JIHicks WHYadav GArmonda RAValadka AB.Surgical treatment of penetrating wounds after resuscitation study: a new classification system for penetrating injuries to the posterior fossa. J Neurosurg. 2025;143(2):443-449."},{"issue":"1","key":"bib22","series-title":"Zaporozhye Med J","first-page":"54","article-title":"Surgical management of battle gunshot injuries to the dural venous sinuses, combined with brain injury: an analysis of series of observations","volume":"22","author":"Pylypenko","year":"2020","unstructured":"Pylypenko HSSirko AHBotikov VV.Surgical management of battle gunshot injuries to the dural venous sinuses, combined with brain injury: an analysis of series of observations. Zaporozhye Med J. 2020;22(1):54-59."},{"issue":"7872","key":"bib23","series-title":"Lancet","first-page":"81","article-title":"Assessment of coma and impaired consciousness. A practical scale","volume":"2","author":"Teasdale","year":"1974","unstructured":"Teasdale GJennett B.Assessment of coma and impaired consciousness. A practical scale. Lancet. 1974;2(7872):81-84."},{"issue":"6","key":"bib24","series-title":"Neurosurgery","first-page":"1173","article-title":"Prediction of outcome in traumatic brain injury with computed tomographic characteristics: a comparison between the computed tomographic classification and combinations of computed tomographic predictors","volume":"57","author":"Maas","year":"2005","unstructured":"Maas AIRHukkelhoven CWPMMarshall LFSteyerberg EW.Prediction of outcome in traumatic brain injury with computed tomographic characteristics: a comparison between the computed tomographic classification and combinations of computed tomographic predictors. Neurosurgery. 2005;57(6):1173-1182."},{"issue":"21","key":"bib25","series-title":"Neurology","first-page":"2244","article-title":"Predicting survival after acute civilian penetrating brain injuries: the SPIN score","volume":"87","author":"Muehlschlegel","year":"2016","unstructured":"Muehlschlegel SAyturk DAhlawat APredicting survival after acute civilian penetrating brain injuries: the SPIN score. Neurology. 2016;87(21):2244-2253."},{"issue":"7905","key":"bib26","series-title":"Lancet","first-page":"480","article-title":"Assessment of outcome after severe brain damage","volume":"1","author":"Jennett","year":"1975","unstructured":"Jennett BBond M.Assessment of outcome after severe brain damage. Lancet. 1975;1(7905):480-484."},{"issue":"4","key":"bib27","series-title":"Neurol Clin","first-page":"943","article-title":"Traumatic injury to the posterior fossa","volume":"32","author":"Nixon","year":"2014","unstructured":"Nixon MAmbekar SZhang STraumatic injury to the posterior fossa. Neurol Clin. 2014;32(4):943-955."},{"key":"bib28","series-title":"World Neurosurg","first-page":"e513","article-title":"Traumatic posterior fossa subdural hemorrhage: a multicenter, retrospective cohort study","volume":"119","author":"Shibahashi","year":"2018","unstructured":"Shibahashi KSugiyama KOkura YHoda HHamabe Y.Traumatic posterior fossa subdural hemorrhage: a multicenter, retrospective cohort study. World Neurosurg. 2018;119:e513-e517."},{"issue":"2","key":"bib29","series-title":"J Trauma Acute Care Surg","first-page":"480","article-title":"Traumatic posterior fossa subdural hematomas","volume":"72","author":"Takeuchi","year":"2012","unstructured":"Takeuchi STakasato YWada KTraumatic posterior fossa subdural hematomas. J Trauma Acute Care Surg. 2012;72(2):480-486."},{"key":"bib30","series-title":"World Neurosurg X","first-page":"100263","article-title":"Management of epidural hematomas of the posterior cranial fossa","volume":"21","author":"Foster","year":"2024","unstructured":"Foster MACollins MRWertin TMAzurdia ARLettieri SCFeiz-Erfan I.Management of epidural hematomas of the posterior cranial fossa. World Neurosurg X. 2024;21:100263."},{"issue":"2","key":"bib31","series-title":"Neurocrit Care","first-page":"686","article-title":"How does the brain die after a massive posterior fossa lesion?","volume":"34","author":"Marcellino","year":"2021","unstructured":"Marcellino CBraksick SAWijdicks EFM.How does the brain die after a massive posterior fossa lesion? Neurocrit Care. 2021;34(2):686-690."},{"key":"bib32","series-title":"Essentials of Terror Medicine","first-page":"313","article-title":"Neurosurgical injury related to terror","author":"Rosenfeld","year":"2009","unstructured":"Rosenfeld JV.Neurosurgical injury related to terror. In: Shapira SC, Hammond JS, Cole LA, eds. Essentials of Terror Medicine. Springer; 2009:313-336."},{"issue":"12","key":"bib33","series-title":"J Neurotrauma","first-page":"1397","article-title":"Neuropathology and pressure in the pig brain resulting from low-impulse noise exposure","volume":"25","author":"S\u00e4lj\u00f6","year":"2008","unstructured":"S\u00e4lj\u00f6 AArrh\u00e9n FBolouri HMayorga MHamberger A.Neuropathology and pressure in the pig brain resulting from low-impulse noise exposure. J Neurotrauma. 2008;25(12):1397-1406."},{"issue":"2","key":"bib34","series-title":"J Neurosurg","first-page":"445","article-title":"Incidence and management of traumatic vertebral artery injuries: wartime experience in Ukraine","volume":"141","author":"Sirko","year":"2024","unstructured":"Sirko ACherednychenko YDowlati EPerepelytsia VArmonda RA.Incidence and management of traumatic vertebral artery injuries: wartime experience in Ukraine. J Neurosurg. 2024;141(2):445-454."},{"key":"bib35","article-title":"19 U.S. troops diagnosed with traumatic brain injury following attacks in Iraq and Syria.","unstructured":"19 U.S. troops diagnosed with traumatic brain injury following attacks in Iraq and Syria.Politico. Accessed October 11, 2025. https:\/\/www.politico.com\/news\/2023\/10\/25\/several-u-s-troops-report-brain-injury-from-attacks-in-iraq-and-syria-00123485"},{"key":"bib36","article-title":"U.S. strikes enemy weapons storage facility in Syria","unstructured":"U.S. strikes enemy weapons storage facility in Syria. US Department of War. Accessed October 11, 2025. https:\/\/www.war.gov\/News\/News-Stories\/Article\/Article\/3585923\/us-strikes-enemy-weapons-storage-facility-in-syria\/"},{"issue":"5","key":"bib37","series-title":"J Med Life","first-page":"459","article-title":"The 20th century: the dawn of modern neurotrauma treatment","volume":"17","author":"Dobran","year":"2024","unstructured":"Dobran SAMuresanu DF.The 20th century: the dawn of modern neurotrauma treatment. J Med Life. 2024;17(5):459-461."},{"key":"bib38","series-title":"World Neurosurg","first-page":"136","article-title":"How war has shaped neurosurgery","volume":"178","author":"Rainone","year":"2023","unstructured":"Rainone GJZelmanovich RLaurent DLucke-Wold B.How war has shaped neurosurgery. World Neurosurg. 2023;178:136-144."},{"issue":"2S suppl 2","key":"bib39","series-title":"J Trauma Acute Care Surg","first-page":"S231","article-title":"Anatomic injury patterns in combat casualties treated by forward surgical teams","volume":"89","author":"Suresh","year":"2020","unstructured":"Suresh MRValdez-Delgado KKVanFosson CAAnatomic injury patterns in combat casualties treated by forward surgical teams. J Trauma Acute Care Surg. 2020;89(2S suppl 2):S231-S236."},{"issue":"19-20","key":"bib40","series-title":"J Neurotrauma","first-page":"1901","article-title":"The Ukraine war: traumatic brain injury in a front-line hospital","volume":"42","author":"Sirko","year":"2025","unstructured":"Sirko AArmonda RABrody DLValadka AB.The Ukraine war: traumatic brain injury in a front-line hospital. J Neurotrauma. 2025;42(19-20):1901-1906."},{"issue":"2","key":"bib41","series-title":"Br J Surg","first-page":"znae324","article-title":"Penetrating traumatic brain injury: a video case presentation","volume":"112","author":"Breton","year":"2025","unstructured":"Breton JMPrvulovic STArmonda RACherednychenko YSirko A.Penetrating traumatic brain injury: a video case presentation. Br J Surg. 2025;112(2):znae324."},{"issue":"11-12","key":"bib42","series-title":"Mil Med","first-page":"e2339","article-title":"The medical implications of emerging unmanned aircraft systems in military and combat environments: a narrative review","volume":"190","author":"Nowadly","year":"2025","unstructured":"Nowadly CDMaddry JKVargas CRThe medical implications of emerging unmanned aircraft systems in military and combat environments: a narrative review. Mil Med. 2025;190(11-12):e2339-e2349."},{"issue":"5","key":"bib1","series-title":"Neurosurgery","first-page":"696","article-title":"Civilian gunshot wounds to the head: a prospective study","volume":"27","author":"Grahm","year":"1990","unstructured":"Grahm TWWilliams FCHarrington TSpetzler RF.Civilian gunshot wounds to the head: a prospective study. Neurosurgery. 1990;27(5):696-700."},{"issue":"3-4","key":"bib2","series-title":"Acta Neurochir (Wien)","first-page":"133","article-title":"Gunshot wounds of the brain in civilians","volume":"94","author":"Cavaliere","year":"1988","unstructured":"Cavaliere RCavenago LSiccardi DViale GL.Gunshot wounds of the brain in civilians. Acta Neurochir (Wien). 1988;94(3-4):133-136."},{"issue":"6","key":"bib3","series-title":"Surg Neurol","first-page":"455","article-title":"Penetrating craniocerebral missile injuries in civilians: a retrospective analysis of 314 cases","volume":"35","author":"Siccardi","year":"1991","unstructured":"Siccardi DCavaliere RPau ALubinu FTurtas SViale GL.Penetrating craniocerebral missile injuries in civilians: a retrospective analysis of 314 cases. Surg Neurol. 1991;35(6):455-460."},{"issue":"1","key":"bib4","series-title":"J Neurosurg","first-page":"9","article-title":"Analysis of 76 civilian craniocerebral gunshot wounds","volume":"65","author":"Clark","year":"1986","unstructured":"Clark WCMuhlbauer MSWatridge CBRay MW.Analysis of 76 civilian craniocerebral gunshot wounds. J Neurosurg. 1986;65(1):9-14."},{"issue":"3","key":"bib5","series-title":"J Neurosurg","first-page":"645","article-title":"Predictors of outcome in civilians with gunshot wounds to the head upon presentation","volume":"121","author":"Gressot","year":"2014","unstructured":"Gressot LVChamoun RBPatel AJPredictors of outcome in civilians with gunshot wounds to the head upon presentation. J Neurosurg. 2014;121(3):645-652."},{"issue":"1","key":"bib6","series-title":"Neurosurg Focus","first-page":"e2","article-title":"Outcome prediction following penetrating craniocerebral injury in a civilian population: aggressive surgical management in patients with admission Glasgow Coma Scale scores of 6 to 15","volume":"8","author":"Levy","year":"2000","unstructured":"Levy ML.Outcome prediction following penetrating craniocerebral injury in a civilian population: aggressive surgical management in patients with admission Glasgow Coma Scale scores of 6 to 15. Neurosurg Focus. 2000;8(1):e2."},{"issue":"4","key":"bib7","series-title":"Neurosurg Clin N Am","first-page":"701","article-title":"Patients with Glasgow Coma Scale scores 3, 4, 5 after gunshot wounds to the brain","volume":"6","author":"Kaufman","year":"1995","unstructured":"Kaufman HHLevy MLStone JLPatients with Glasgow Coma Scale scores 3, 4, 5 after gunshot wounds to the brain. Neurosurg Clin N Am. 1995;6(4):701-714."},{"issue":"5","key":"bib8","series-title":"Neurosurgery","first-page":"533","article-title":"Civilian gunshot wounds to the brain: prognosis and management","volume":"18","author":"Nagib","year":"1986","unstructured":"Nagib MGRockswold GLSherman RSLagaard MW.Civilian gunshot wounds to the brain: prognosis and management. Neurosurgery. 1986;18(5):533-537."},{"issue":"2","key":"bib9","series-title":"Surg Neurol","first-page":"98","article-title":"Prognostic factors and treatment of penetrating gunshot wounds to the head","volume":"60","author":"Martins","year":"2003","unstructured":"Martins RSSiqueira MGSantos MTSZanon-Collange NMoraes OJS.Prognostic factors and treatment of penetrating gunshot wounds to the head. Surg Neurol. 2003;60(2):98-104."},{"issue":"12","key":"bib10","series-title":"Am Surg","first-page":"1009","article-title":"Civilian craniocerebral gunshot wounds: an update in predicting outcomes","volume":"71","author":"Murano","year":"2005","unstructured":"Murano TMohr AMLavery RFLynch CHomnick ATLivingston DH.Civilian craniocerebral gunshot wounds: an update in predicting outcomes. Am Surg. 2005;71(12):1009-1014."},{"issue":"4","key":"bib11","series-title":"Neurosurg Rev","first-page":"231","article-title":"Analysis of 107 civilian craniocerebral gunshot wounds","volume":"25","author":"Ozkan","year":"2002","unstructured":"Ozkan UKemalo\u011flu SOzate\u015f MAydin MD.Analysis of 107 civilian craniocerebral gunshot wounds. Neurosurg Rev. 2002;25(4):231-236."},{"issue":"1-2","key":"bib12","series-title":"Acta Neurochir (Wien)","first-page":"27","article-title":"The early prognosis of craniocerebral gunshot wounds in civilian practice as an aid to the choice of treatment. A series of 56 cases studied by the computerized tomography","volume":"74","author":"Shoung","year":"1985","unstructured":"Shoung HMSichez JPPertuiset B.The early prognosis of craniocerebral gunshot wounds in civilian practice as an aid to the choice of treatment. A series of 56 cases studied by the computerized tomography. Acta Neurochir (Wien). 1985;74(1-2):27-30."},{"issue":"6","key":"bib13","series-title":"Neurosurgery","first-page":"689","article-title":"Gunshot wounds to the head: a perspective","volume":"18","author":"Kaufman","year":"1986","unstructured":"Kaufman HHMakela MELee KFHaid RWGildenberg PL.Gunshot wounds to the head: a perspective. Neurosurgery. 1986;18(6):689-695."},{"issue":"1","key":"bib14","series-title":"Neurosurgery","first-page":"77","article-title":"Outcome prediction after penetrating craniocerebral injury in a civilian population: aggressive surgical management in patients with admission Glasgow Coma Scale scores of 3, 4, or 5","volume":"35","author":"Levy","year":"1994","unstructured":"Levy MLMasri LSLavine SApuzzo ML.Outcome prediction after penetrating craniocerebral injury in a civilian population: aggressive surgical management in patients with admission Glasgow Coma Scale scores of 3, 4, or 5. Neurosurgery. 1994;35(1):77-85."},{"issue":"4","key":"bib15","series-title":"Neurosurg Clin N Am","first-page":"689","article-title":"Multivariate analysis and prediction of outcome following penetrating head injury","volume":"6","author":"Polin","year":"1995","unstructured":"Polin RSShaffrey MEPhillips CDGermanson TJane JA.Multivariate analysis and prediction of outcome following penetrating head injury. Neurosurg Clin N Am. 1995;6(4):689-699."},{"issue":"5-6","key":"bib16","series-title":"Mil Med","first-page":"e774","article-title":"Mortality and functional outcome predictors in combat-related penetrating brain injury treatment in a specialty civilian medical facility","volume":"185","author":"Sirko","year":"2020","unstructured":"Sirko APilipenko GRomanukha DSkrypnik A.Mortality and functional outcome predictors in combat-related penetrating brain injury treatment in a specialty civilian medical facility. Mil Med. 2020;185(5-6):e774-e780."},{"issue":"4","key":"bib17","series-title":"Neurosurg Clin N Am","first-page":"715","article-title":"Penetrating injuries in the Vietnam War. Traumatic unconsciousness, epilepsy, and psychosocial outcome","volume":"6","author":"Salazar","year":"1995","unstructured":"Salazar AMSchwab KGrafman JH.Penetrating injuries in the Vietnam War. Traumatic unconsciousness, epilepsy, and psychosocial outcome. Neurosurg Clin N Am. 1995;6(4):715-726."},{"issue":"5","key":"bib18","series-title":"Neurosurgery","first-page":"692","article-title":"Surgical outcome in 435 patients who sustained missile head wounds during the Iran\u2013Iraq War","volume":"27","author":"Aarabi","year":"1990","unstructured":"Aarabi B.Surgical outcome in 435 patients who sustained missile head wounds during the Iran\u2013Iraq War. Neurosurgery. 1990;27(5):692-695."},{"issue":"1","key":"bib19","series-title":"J Surg Emerg Med","article-title":"Blast scaling parameters: transitioning from lung to skull base metrics","volume":"1","author":"Lucke-Wold","year":"2017","unstructured":"Lucke-Wold BPTurner RCLogsdon AFRosen CLQaiser R.Blast scaling parameters: transitioning from lung to skull base metrics. J Surg Emerg Med. 2017;1(1):3."},{"issue":"3-4","key":"bib20","series-title":"Surg Neurol","first-page":"225","article-title":"Civilian infratentorial gunshot injuries: outcome analysis of 26 patients","volume":"58","author":"Nathoo","year":"2002","unstructured":"Nathoo NChite SHEdwards PJvan Dellen JR.Civilian infratentorial gunshot injuries: outcome analysis of 26 patients. Surg Neurol. 2002;58(3-4):225-233."},{"issue":"2","key":"bib21","series-title":"J Neurosurg","first-page":"443","article-title":"Surgical treatment of penetrating wounds after resuscitation study: a new classification system for penetrating injuries to the posterior fossa","volume":"143","author":"Sirko","year":"2025","unstructured":"Sirko ATraylor JIHicks WHYadav GArmonda RAValadka AB.Surgical treatment of penetrating wounds after resuscitation study: a new classification system for penetrating injuries to the posterior fossa. J Neurosurg. 2025;143(2):443-449."},{"issue":"1","key":"bib22","series-title":"Zaporozhye Med J","first-page":"54","article-title":"Surgical management of battle gunshot injuries to the dural venous sinuses, combined with brain injury: an analysis of series of observations","volume":"22","author":"Pylypenko","year":"2020","unstructured":"Pylypenko HSSirko AHBotikov VV.Surgical management of battle gunshot injuries to the dural venous sinuses, combined with brain injury: an analysis of series of observations. Zaporozhye Med J. 2020;22(1):54-59."},{"issue":"7872","key":"bib23","series-title":"Lancet","first-page":"81","article-title":"Assessment of coma and impaired consciousness. A practical scale","volume":"2","author":"Teasdale","year":"1974","unstructured":"Teasdale GJennett B.Assessment of coma and impaired consciousness. A practical scale. Lancet. 1974;2(7872):81-84."},{"issue":"6","key":"bib24","series-title":"Neurosurgery","first-page":"1173","article-title":"Prediction of outcome in traumatic brain injury with computed tomographic characteristics: a comparison between the computed tomographic classification and combinations of computed tomographic predictors","volume":"57","author":"Maas","year":"2005","unstructured":"Maas AIRHukkelhoven CWPMMarshall LFSteyerberg EW.Prediction of outcome in traumatic brain injury with computed tomographic characteristics: a comparison between the computed tomographic classification and combinations of computed tomographic predictors. Neurosurgery. 2005;57(6):1173-1182."},{"issue":"21","key":"bib25","series-title":"Neurology","first-page":"2244","article-title":"Predicting survival after acute civilian penetrating brain injuries: the SPIN score","volume":"87","author":"Muehlschlegel","year":"2016","unstructured":"Muehlschlegel SAyturk DAhlawat APredicting survival after acute civilian penetrating brain injuries: the SPIN score. Neurology. 2016;87(21):2244-2253."},{"issue":"7905","key":"bib26","series-title":"Lancet","first-page":"480","article-title":"Assessment of outcome after severe brain damage","volume":"1","author":"Jennett","year":"1975","unstructured":"Jennett BBond M.Assessment of outcome after severe brain damage. Lancet. 1975;1(7905):480-484."},{"issue":"4","key":"bib27","series-title":"Neurol Clin","first-page":"943","article-title":"Traumatic injury to the posterior fossa","volume":"32","author":"Nixon","year":"2014","unstructured":"Nixon MAmbekar SZhang STraumatic injury to the posterior fossa. Neurol Clin. 2014;32(4):943-955."},{"key":"bib28","series-title":"World Neurosurg","first-page":"e513","article-title":"Traumatic posterior fossa subdural hemorrhage: a multicenter, retrospective cohort study","volume":"119","author":"Shibahashi","year":"2018","unstructured":"Shibahashi KSugiyama KOkura YHoda HHamabe Y.Traumatic posterior fossa subdural hemorrhage: a multicenter, retrospective cohort study. World Neurosurg. 2018;119:e513-e517."},{"issue":"2","key":"bib29","series-title":"J Trauma Acute Care Surg","first-page":"480","article-title":"Traumatic posterior fossa subdural hematomas","volume":"72","author":"Takeuchi","year":"2012","unstructured":"Takeuchi STakasato YWada KTraumatic posterior fossa subdural hematomas. J Trauma Acute Care Surg. 2012;72(2):480-486."},{"key":"bib30","series-title":"World Neurosurg X","first-page":"100263","article-title":"Management of epidural hematomas of the posterior cranial fossa","volume":"21","author":"Foster","year":"2024","unstructured":"Foster MACollins MRWertin TMAzurdia ARLettieri SCFeiz-Erfan I.Management of epidural hematomas of the posterior cranial fossa. World Neurosurg X. 2024;21:100263."},{"issue":"2","key":"bib31","series-title":"Neurocrit Care","first-page":"686","article-title":"How does the brain die after a massive posterior fossa lesion?","volume":"34","author":"Marcellino","year":"2021","unstructured":"Marcellino CBraksick SAWijdicks EFM.How does the brain die after a massive posterior fossa lesion? Neurocrit Care. 2021;34(2):686-690."},{"key":"bib32","series-title":"Essentials of Terror Medicine","first-page":"313","article-title":"Neurosurgical injury related to terror","author":"Rosenfeld","year":"2009","unstructured":"Rosenfeld JV.Neurosurgical injury related to terror. In: Shapira SC, Hammond JS, Cole LA, eds. Essentials of Terror Medicine. Springer; 2009:313-336."},{"issue":"12","key":"bib33","series-title":"J Neurotrauma","first-page":"1397","article-title":"Neuropathology and pressure in the pig brain resulting from low-impulse noise exposure","volume":"25","author":"S\u00e4lj\u00f6","year":"2008","unstructured":"S\u00e4lj\u00f6 AArrh\u00e9n FBolouri HMayorga MHamberger A.Neuropathology and pressure in the pig brain resulting from low-impulse noise exposure. J Neurotrauma. 2008;25(12):1397-1406."},{"issue":"2","key":"bib34","series-title":"J Neurosurg","first-page":"445","article-title":"Incidence and management of traumatic vertebral artery injuries: wartime experience in Ukraine","volume":"141","author":"Sirko","year":"2024","unstructured":"Sirko ACherednychenko YDowlati EPerepelytsia VArmonda RA.Incidence and management of traumatic vertebral artery injuries: wartime experience in Ukraine. J Neurosurg. 2024;141(2):445-454."},{"key":"bib35","article-title":"19 U.S. troops diagnosed with traumatic brain injury following attacks in Iraq and Syria.","unstructured":"19 U.S. troops diagnosed with traumatic brain injury following attacks in Iraq and Syria.Politico. Accessed October 11, 2025. https:\/\/www.politico.com\/news\/2023\/10\/25\/several-u-s-troops-report-brain-injury-from-attacks-in-iraq-and-syria-00123485"},{"key":"bib36","article-title":"U.S. strikes enemy weapons storage facility in Syria","unstructured":"U.S. strikes enemy weapons storage facility in Syria. US Department of War. Accessed October 11, 2025. https:\/\/www.war.gov\/News\/News-Stories\/Article\/Article\/3585923\/us-strikes-enemy-weapons-storage-facility-in-syria\/"},{"issue":"5","key":"bib37","series-title":"J Med Life","first-page":"459","article-title":"The 20th century: the dawn of modern neurotrauma treatment","volume":"17","author":"Dobran","year":"2024","unstructured":"Dobran SAMuresanu DF.The 20th century: the dawn of modern neurotrauma treatment. J Med Life. 2024;17(5):459-461."},{"key":"bib38","series-title":"World Neurosurg","first-page":"136","article-title":"How war has shaped neurosurgery","volume":"178","author":"Rainone","year":"2023","unstructured":"Rainone GJZelmanovich RLaurent DLucke-Wold B.How war has shaped neurosurgery. World Neurosurg. 2023;178:136-144."},{"issue":"2S suppl 2","key":"bib39","series-title":"J Trauma Acute Care Surg","first-page":"S231","article-title":"Anatomic injury patterns in combat casualties treated by forward surgical teams","volume":"89","author":"Suresh","year":"2020","unstructured":"Suresh MRValdez-Delgado KKVanFosson CAAnatomic injury patterns in combat casualties treated by forward surgical teams. J Trauma Acute Care Surg. 2020;89(2S suppl 2):S231-S236."},{"issue":"19-20","key":"bib40","series-title":"J Neurotrauma","first-page":"1901","article-title":"The Ukraine war: traumatic brain injury in a front-line hospital","volume":"42","author":"Sirko","year":"2025","unstructured":"Sirko AArmonda RABrody DLValadka AB.The Ukraine war: traumatic brain injury in a front-line hospital. J Neurotrauma. 2025;42(19-20):1901-1906."},{"issue":"2","key":"bib41","series-title":"Br J Surg","first-page":"znae324","article-title":"Penetrating traumatic brain injury: a video case presentation","volume":"112","author":"Breton","year":"2025","unstructured":"Breton JMPrvulovic STArmonda RACherednychenko YSirko A.Penetrating traumatic brain injury: a video case presentation. Br J Surg. 2025;112(2):znae324."},{"issue":"11-12","key":"bib42","series-title":"Mil Med","first-page":"e2339","article-title":"The medical implications of emerging unmanned aircraft systems in military and combat environments: a narrative review","volume":"190","author":"Nowadly","year":"2025","unstructured":"Nowadly CDMaddry JKVargas CRThe medical implications of emerging unmanned aircraft systems in military and combat environments: a narrative review. Mil Med. 2025;190(11-12):e2339-e2349."}],"container-title":["Journal of Neurosurgery: Case Lessons"],"original-title":[],"link":[{"URL":"https:\/\/thejns.org\/view\/journals\/j-neurosurg-case-lessons\/11\/1\/article-CASE25563.xml","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/thejns.org\/downloadpdf\/journals\/j-neurosurg-case-lessons\/11\/1\/article-CASE25563.xml","content-type":"text\/html","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/thejns.org\/downloadpdf\/journals\/j-neurosurg-case-lessons\/11\/1\/article-CASE25563.xml","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,4,13]],"date-time":"2026-04-13T15:27:17Z","timestamp":1776094037000},"score":1,"resource":{"primary":{"URL":"https:\/\/thejns.org\/view\/journals\/j-neurosurg-case-lessons\/11\/1\/article-CASE25563.xml"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,1,5]]},"references-count":84,"journal-issue":{"issue":"1"},"URL":"https:\/\/doi.org\/10.3171\/case25563","relation":{},"ISSN":["2694-1902"],"issn-type":[{"value":"2694-1902","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,1,5]]}}}