Rehabilitation outcome of combat head injuries: Comparison of October 1973 war and Lebanon war, 1982

A comparative study between two series of penetrating head injuries that occurred during the October 1973 (Yom Kippur) War and the Lebanon War, 1982, was conducted following the clinical impression that patients wounded in 1982 experienced shorter periods of unconsciousness. Patients in both series were of similar age and educational levels. Duration of coma was shorter, transfer to rehabilitation hospitals quicker and the overall hospital stay shorter, all significantly so, in the 1982 series. Other significant differences were the abundance of associated chest and abdominal injuries in the 1982 series and the fact that not a single patient underwent tracheostomy in the later series, in contrast to 64% of the 1973 patients. No differences were noted with regard to neurological sequelae, independence in activities of daily living, and high mental functions. Rehabilitation outcome, as evaluated by actual work placement, differed significantly in favor of the 1982 series. This was probably due to faster patient transfer to rear hospitals for definitive interventions, thus reducing secondary brain damage and resulting in shorter period of unconsciousness.