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Objective:To investigate the significance of ventricular intracranial pressure monitoring in the treatment of traumatic multiple intracranial hematoma (TMIH).Methods:The clinical data of 14 TMIH patients treated with ventricular intracranial pressure monitoring from January 2016 to August 2021 in Beijing Luhe Hospital, Capital Medical University were analyzed retrospectively. The patients were followed up 6 months after injury, and the Glasgow outcome score (GOS) was assessed.Results:All the 14 patients successfully completed ventricular intracranial pressure probe placement. Among them, 8 patients recovered well after continuous monitoring of ventricular intracranial pressure and continuous cerebrospinal fluid drainage. Their ventricular intracranial pressure probe was placed for 5 to 10 (7.3 ± 2.2) d, with no intracranial infection occurred; and their GOS was 5 scores 6-month follow-up after injury. Six cases underwent craniotomy for hematoma removal due to the expansion of intracranial hematoma or aggravation of edema, and decompressive craniectomy was performed during the operation; 6-month follow-up after injury, GOS of 5 scores was in 3 cases, 4 scores in 2 cases, 3 scores in 1 case.Conclusions:The condition of TMIH patients is complex and changeable, and ventricular intracranial pressure monitoring can improve the prognosis of TMIH patients.
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Objective To investigate the risk factors of progressive intracerebral hematoma (PIH) in severe traumatic brain injury (STBI) and provide reference for diagnosis and treatment of STBI.Methods The clinical information of 96 patients of STBI from March 2008 to March 2012 were retrospectively analyzed,the risk factors of PIH were analyzed by the univariate and multivariate Logistic regression analysis.Results Thirty-six patients occurred PIH,the incidence rate of PIH was 37.5％ (36/96).The univariate regression analysis showed that the age,admission GCS scores,injury to the first CT time,brain contusion,subarachnoid hemorrhage,epidural hematoma,subdural hematoma had certain relation with PIH (P ＜ 0.01or ＜ 0.05).Multivariate Logistic regression analysis showed that the age,brain contusion,subarachnoid hemorrhage,epidural hematoma,subdural hematoma were risk factors of PIH (P ＜0.05 or ＜0.01).Conclusion Fully aware of the risk factors of PIH and timely intervention is the key to reduce the morbidity and mortality of STBI.
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ObjectiveTo explore the effect of combined usage of expanding coronal decompressive craniectomy and sequential dural incision for treating severe bilateral frontal contusion (SBFC).Methods Forty-three patients with SBFC were randomly divided by sequential single day after hospitalization into two groups.Observation group(23 cases) treated with expanding coronal decompressive craniectomy and sequential dural incision.Control group (20 cases) treated with standard hemicraniectomy and routine dural incision.ResultsThe occurrence rate of acute cephalocele was significantly lower in observation group [ 17.4％(4/23) ] than that in control group [ 55.0％(11/20) ] (P ＜ 0.05).According to Glasgow outcome scale (GOS) score of six-month observation after operation,17 cases(73.9％,17/23) of observation group got favourable recovery or moderate deficit,other 6 cases(26.1％,6/23) got severe deficit,persistent vegetative status or death.While only 8 cases(40.0％,8/20) got favourable recovery or moderate deficit,12 cases ( 60.0％,12/20 ) got severe deficit,persistent vegetative status or death in control group.The rate of favourable recovery and moderate deficit of two groups had statistical significance (P ＜ 0.05).ConclusionCombination application of expanding coronal decompressive craniectomy and sequential dural incision is an effective method to treat patients with SBFC,and can obviously improve the rate of successful rescue and decrease the rate of mortality and disability.
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Objective To investigate the clinical significance of leukocyte count and neutrophil count change on delayed traumatic intracranial hemorrhage(DTIH).Method Collected the peripheral venous blood of l 16 eases of DTIH and 123 cases of non-DTIH between June 2005 and Deeember 2007.Compared the leukocyte count and neutrophil count in all cases by different groups.Results The leukocyte count and neutrophil count of the DTIH patients whose first CT scan were negative[(13.35±6.72)×109/Land(12.78±6.43)×109/L,respectively]were significantly higher than those of head injury whose CT scan werenegative allthetime[(9.72±3.09)×109/Land(7.64±2.93)×109/L,respectively].The difference was significant (P＜0.01).There were no statistical significance of the leukocyte count and neutrophil count between DTIH patients and non-DTIH patients whose first CT scan were positive(P＞0.05).Conclusions As an independent guideline,the leukocyte count and neutrophil count may help the forepart diagnosis of DTIH patients whose first CT scan were negative.
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Objective To explore the early diagnosis and treatment of delayed intraeranial haematoma.Methods To analyze the patients that were detected haematoma by first CT examine m Hospital, but were diagnosis of intracranial haematome consequently by CT reexamine and ICP monitor. Results 66 patients of delayed intracranial haematoma were evacuated and 30 patients died. The operative mortality was 45.5 %. Conclusion To burr bole in time and repeat CT scan will improve the prognosis of acute eneephalocele and deteriorating patients.