The book describes Ukrainian neurosurgeons’ hard-won experience and lessons learned about managing combat-related neurotrauma. This is not a weighty tome with long discussions of pathophysiology, epidemiology, and similar topics. Instead, this is a very concise and practical “how to” guide for describing surgical and perioperative management of patients with penetrating brain injury, cerebrovascular injury, and trauma to the spine, spinal cord, and peripheral nerves.

The authors at Mechnikov Hospital have acquired unique immersive and ongoing experience in management of these injuries since the war began in 2014 and especially since the full-scale invasion was launched in February 2022. Their management protocols and surgical techniques have redefined state-of-the-art management of these injuries.

Armed conflict is expected to rise globally, and specialists such as neurosurgeons, orthopedic surgeons, trauma surgeons, plastic surgeons, and interventional neuroradiologists will be required to treat combat injuries for which many have little or no experience. The trauma patterns seen in the Ukraine war are unlike those of previous conflicts, making practical, immediately applicable guidance essential. Clinicians caring for these patients will not have time for lengthy scientific background. They need clear, concise, clinically focused instructions at the bedside. No current manuals address these specific injury patterns. A compact printed guide will be especially critical in future near‑peer conflicts, where secure communication may be impossible. This book provides that essential resource.

The concise text is supplemented with numerous illustrations to facilitate understanding and, most importantly, to optimize patient care. Many providers who practice in civilian settings will also benefit from the information in this book.

Professor Andrii Sirko is a Ukrainian neurosurgeon, academic leader, and expert in complex cranial and cerebrovascular surgery, with extensive experience in both civilian and wartime neurosurgical care. He currently serves as President of the Ukrainian Neurosurgical Association and Head of the Center of Cerebral Neurosurgery at the Mechnikov Dnipropetrovsk Regional Clinical Hospital, one of Ukraine’s leading tertiary referral centers. He received his medical education and advanced neurosurgical training in Ukraine, followed by academic and clinical specialization in cerebrovascular surgery, skull base surgery, neurotrauma, and critical neurosurgical care. He has been actively involved in neurosurgical education and research for more than two decades. Since the beginning of the full-scale war in Ukraine, Professor Sirko has played a central role in organizing and delivering neurosurgical care for both civilian and military casualties. His center has treated a large volume of patients with penetrating brain injuries, blast-related neurotrauma, complex cranial wounds, and vascular complications associated with modern warfare. This experience has significantly shaped his clinical and academic focus on damage control neurosurgery, staged surgical strategies, and multidisciplinary management under conditions of limited resources and ongoing risk.

Rocco Armonda is Professor of Neurosurgery at Georgetown University Hospital and Professor and Director of Neurosurgery at Uniformed Services University of the Health Sciences (USUHS). He focuses on the areas of cerebrovascular disease, neurotrauma, and neurocritical care. He has advanced the use of multi-modal monitoring in the military as well as treatment techniques for patients with neurotrauma and stroke that include both invasive and non-invasive monitoring. His seminal work includes the detection and treatment of traumatic cerebral vasospasm, traumatic pseudoaneurysms, decompressive craniectomy for wartime trauma, post-traumatic craniofacial reconstruction, multimodal treatment of arteriovenous malformations, and the design and deployment of the advanced neurointerventional operating room. His research efforts include clinical studies on the long-term outcomes of wartime posthemicraniectomy patients, nanotechnology-designed biologically active stents for neurovascular disease, non-invasive monitoring of cerebral blood flow, the neurovascular effects of blast injuries, and neurosurgical simulators for hemicraniectomy training modules.

Alex Valadka serves as Professor of Neurological Surgery at the University of Texas Southwestern Medical Center in Dallas, where he is also Chief of Neurological Surgery at Parkland Memorial Hospital. He has had a career-long clinical and research interest in neurotrauma and neurocritical care. He has served in numerous leadership roles in neurosurgery and neurotrauma, including President of the American Association of Neurological Surgeons, Vice Chair of the American Board of Neurological Surgery, Chair of the Neurosurgical Specialty Group of the American College of Surgeons Committee on Trauma, and membership on numerous study sections, data and safety monitoring boards, and similar activities for the NIH and other organizations.