Experience with Augmented Reality Technology in the Removal of Foreign Bodies Following Combat-Related Penetrating Brain Injury

Vollständiger Abstract

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Background: Advances in modern military technology have resulted in an increased incidence of severe combat-related traumatic brain injuries. Penetrating cranial and brain injuries affect both military personnel and civilians, highlighting their significant medical and societal impact. Such injuries may result in severe neurological deficits and profound disability, while secondary complications may further exacerbate the patient’s condition and increase the risk of mortality. The management of retained foreign bodies remains controversial. Their removal using conventional navigation techniques, including anatomical landmarks and intraoperative fluoroscopy, may result in suboptimal surgical trajectories, leading to additional injury to the surrounding brain tissue, prolonged operative time, increased radiation exposure for both the patient and the surgical team, and postoperative complications such as intracerebral hematoma and cerebral ischemia. The application of augmented reality technology combined with minimally invasive instruments may significantly reduce the risk of perioperative complications. Clinical case: This study presents a clinical case of retained foreign body removal using augmented reality and endoscope after a penetrating head injury. The patient was treated at the Neurosurgical Center of Main Military Clinical Hospital named after Academician N.N. Burdenko. During postoperative follow-up, favorable clinical outcomes were observed, with no progression of neurological deficits. Based on this clinical case, indications for the application of this technology in the management of combat-related head injuries were proposed. These indications may be further expanded with the wider implementation of this approach in clinical practice. Future prospective for the development of this approach are also discussed.