Military neurosurgery
Larrey, a French military surgeon during Napoleon’s campaigns, affirmed that trepanation was “without exception, the most difficult part of military surgery 1).
Time devoted to surgical predeployment training would never be sufficient, to face the large and miscellaneous aspects of war-related injuries. Concerning neurosurgery, it evolved from a 70-day training period during the First World War and a longer 4-month program during the Second World conflict, 2) to only several hours during the current French Advance Course for Deployment Surgery (ACDS) 3).
Teleassistance including transfer of images can be helpful to guide indication and surgical planning 4).
Military traumatic brain injury
1)
Roux FE, Reddy M. Neurosurgical work during
the Napoleonic wars: Baron Larrey's experience.
Clin Neurol Neurosurg. 2013;115:2438–2444.
2)
Dowdy J, Pait TG. The influence of war on the
development of neurosurgery. J Neurosurg.
2014;120:237–243.
3)
Bonnet S, Gonzalez F, Mathieu L, Boddaert G,
Hornez E, Bertani A, Avaro JP, Durand X,
Rongieras F, Balandraud P, et al. The French Advanced
Course for deployment Surgery (ACDS)
called cours avancé de chirurgie en mission
extérieure (CACHIRMEX): history of its development
and future prospects. J R Army Med
Corps. 2016;162(5):343–347.
4)
Dulou R, Dagain A, Delmas JM, Lambert E,
Blondet E, Goasguen O, Pouit B, Dutertre G, de
Soultrait F, Pernot P. The French mobile neurosurgical
unit. Neurosurg Focus. 2010;28(5):E13.