Missile Injuries Of The Brain Spine And Peripheral Nerves, 2nd Edition [Original PDF Download]

Missile Injuries Of The Brain Spine And Peripheral Nerves


“Missile Injuries of the Brain, Spine and Peripheral Nerves,” the book by Brigadier (Retired) Harjinder Singh Bhatoe, published by Thieme Medical Publishers in 2019, is a ready-reference comprehensive book for neurosurgeons who may have to deal with gunshot or missile injuries.

Craniocerebral missile injuries carry very high mortality rates (75–80%) and most patients succumb even before they get examined by neurosurgeons. Literature and publications on gunshot and missile wounds of the brain and spine are scant.

This book begins with a note on the historical perspectives of early missiles, discusses the evolution in the management of missile injuries, and recounts the Indian experience. Special highlights of the book include the concept and principles of ballistics as well as the pathophysiology of gunshot (and shrapnel) injuries, with their easy correlation with the diagnostic imaging in a simplified manner. An exhaustive coverage on management, critical care, and controversies related to different types of gunshot wounds is also included. This book has meticulously selected illustrations to aid in the understanding of the injuries and in planning their treatment and prognostication.

The book also discusses pre-hospital algorithms and the clinical evaluation of war-wounded patients in great details. A chapter on the surgical and post-operative management is worth reading as it discusses when to operate and how aggressive one should be in such life-threatening injuries wherein the surgery may have to be done under less-than-ideal conditions, with resources that are barely sufficient and with the biological clock ticking away. The common query by most readers is related to the steps to be undertaken with retained splinters and the management of non-missile penetrating craniocerebral injuries. These areas are discussed well in this book. To make it a comprehensive textbook, the author has taken care to include two interesting chapters on spinal and peripheral nerve gunshot injuries also. This 14-chapter, approximately 250-page book is replete with colored images and illustrations for an easy understanding of the subject matter by the reader.

Armed conflict has always provided any surgeon with an opportunity to advance the science of trauma surgery. In the words of Hippocrates, “Let him who wishes to be a surgeon go to war.” Ambroise Paré further reiterated, “In the pursuit of his profession, a surgeon can wish no more welcome test of fire than the battlefield.” Once considered the exclusive domain of military neurosurgeons, cranial and spinal gunshot wounds are now increasingly seen in the civilian population and it is important for all those dealing with neurotrauma care to understand the special issues involved related to missile injuries of the brain and spine/peripheral nerves.

An interesting highlight of the book is that each chapter begins with an anecdote wherein some top neurosurgeons or wartime heroes have been quoted. Credit should be given to the author for keeping the reader relaxed even as they go through the intense content of the book.

Sample this: “Goli maar bheje mein.”, (“place a bullet through the brain…) song in Hindi film “Satya”, critically acclaimed for its realistic depiction of the Mumbai underworld

“Gun control opponents like to say ‘guns don’t kill people, people kill people.’ But people with guns kill people more often and efficiently than people without guns. Guns may not cause violence, but they make violence more severe, more likely to lead to death instead of just injury.” Cotton P, et al. JAMA 1992; 267:1171–74.

The previous book on ‘Missile Wounds of the Head and Neck’ (a 2-volume set) was published by AANS by Bizhan Aarabi et al., in 1999.[1],[2]

I am glad that we, in India, now have one entire book focused on these injuries, and who better to discuss the topic than those who deal with it most frequently, the neurosurgeons of the Armed Forces. Here, I would like to mention the efforts of Brigadier (Dr.) Harjinder Singh Bhatoe in bringing out a textbook dedicated to gunshot and missile injuries, the first such effort in this country. The book has been the result of years of toiling with data, references, and images. I am sure this book will fill a major void in the neurotrauma scenario, and the surgeons and neurosurgeons who grapple with such injuries will find it extremely useful. Its content is primarily based on the author’s experience during his time spent in the Indian Army Medical Corps, treating victims of wartime zone at various time points. He should be congratulated for bringing out this superb comprehensive book on missile injuries of the brain, spinal cord, and peripheral nerves. This book will be of immense value to neurosurgeons and trauma surgeons in India and overseas.