Safe management of paediatric penetrating head injury without a CT scanner: A strategy for humanitarian surgeons based on experience in southern Afghanistan.

Introduction: In many parts of the world, access to a CT scanner remains almost non-existent, and patients with a head injury are managed expectantly, often with poor results. Recent military medical experience in southern Afghanistan using a well-equipped surgical facility with a CT scanner has provided new insights into safe surgical practice in resource-poor environments.

Methods: All cases of children aged under 16 years with penetrating head injury who were treated in a trauma unit in southern Afghanistan by a single neurosurgeon between 2008 and 2010 were reviewed.

Evidence for perceptual learning with repeated stimulation after partial and total cortical blindness.

Lesions of occipital cortex result in loss of sight in the corresponding regions of visual fields. The traditional view that, apart from some spontaneous recovery in the acute phase, field defects remain permanently and irreversibly blind, has been challenged. In patients with partial field loss, a range of residual visual abilities in the absence of conscious perception (blindsight) has been demonstrated (Weiskrantz, 1986).