title: Massive pediatric neurosurgical injuries and lessons learned following a tornado disaster in Alabama.
abstract: OBJECTIVE
  A large volume of patients presented to a Level I pediatric trauma center during and after a recent tornado disaster. Injuries of the central and peripheral nervous systems and the medical responses of a pediatric neurosurgical team are reviewed.
  
  
  METHODS
  The clinical courses of patients who suffered cranial, spinal, and peripheral nerve injuries due to the tornado storm are reported. The clinical actions taken by the neurosurgical team during and after the event are reviewed and the lessons learned are discussed.
  
  
  RESULTS
  The tornado storm system moved through the Tuscaloosa and Birmingham metropolitan areas on the early evening hours of April 27, 2011. Twenty-four patients received care from the neurosurgical team. A total of 11 cranial (including placement of an external ventricular drain), 2 spine, and 2 peripheral procedures were performed for the victims. Nine procedures were performed within the first 12 hours of the event, and an additional 6 surgeries were performed in the following 24 hours. Injuries of the peripheral nervous system often presented in a delayed fashion. Several key components were identified that enabled adequate neurosurgical care for a large influx of acute patients.
  
  
  CONCLUSIONS
  Massive casualties due to tornados are rare. A well-organized physician team working with the hospital administration may decrease the mortality and morbidity of such events.
authors: Pediatric Neurosurgery, Children's Hospital, Birmingham, Alabama 35233, USA. jc691586@gmail.com
authors: Joshua J
authors: JJ
authors: Chern
authors: Joseph H
authors: JH
authors: Miller
authors: R Shane
authors: RS
authors: Tubbs
authors: Thomas R
authors: TR
authors: Whisenhunt
authors: James M
authors: JM
authors: Johnston
authors: John C
authors: JC
authors: Wellons
authors: Curtis J
authors: CJ
authors: Rozzelle
authors: Jeffrey P
authors: JP
authors: Blount
authors: W Jerry
authors: WJ
authors: Oakes
mesh_terms: D000407:Alabama; D002648:Child; D002675:Child, Preschool; D020209:Cranial Nerve Injuries / Q000601:surgery*; D004190:Disasters; D005260:Female; D006801:Humans; D008297:Male; D009493:Neurosurgery; D019635:Neurosurgical Procedures / Q000379:methods; D059348:Peripheral Nerve Injuries / Q000601:surgery*; D013124:Spinal Injuries / Q000601:surgery*; D055869:Tornadoes; D014193:Trauma Centers