Craniectomía descompresiva como tratamiento primario de la hipertensión intracraneal por traumatismo encefalocraneano: Experiencia observacional en 24 pacientes

RESUMEN

Introducción: el traumatismo encéfalo craneano es una de las principales causas de muerte en nuestro medio, El tratamiento médico y quirúrgico en la etapa inicial de un TEC severo se enfoca en evitar la elevación de la Presión Intracraneana. Objetivo: describir características asociados y sus principales complicaciones en aquellos pacientes sometidos a Craniectomía Descompresiva. Métodos: Estudio retrospectivo observacional descriptivo, realizado entre febrero de 2018 a julio de 2020 de pacientes operados de Craniectomía Descompresiva unilateral, admitidos por traumatismo encefalocraneano. Resultados: 66.7% fueron personas menores de 40 años; 87,5% fueron de sexo masculino; 16,7% de la población ingresaron con una ECG de 13-15, 37,5% de la población con una ECG de 9-12; 42.9% presentaron asimetría pupilar; 33,3% ingresaron por accidente de tránsito; 21,7% fueron Marshall II, 65,2% Marshall III y en 13,0% se halló un Marshall IV. Conclusiones: Los resultados sugieren que las características asociadas a la Craniectomía Descompresiva por TEC contribuyen en el manejo de esta patología.

ABSTRACT

Introduction: Head trauma is one of the main causes of death in Peru. Medical and surgical therapy during the initial stages of severe head trauma focus in preventing the elevation of intracranial pressure. Objective: To describe the associated characteristics and main complications in patients undergoing decompressive craniectomy. Methods: This is a retrospective observational study performed between February 2018 and July 2020 in patients who had been admitted because of head trauma and who had undergone unilateral decompressive craniectomy. Results: Two-thirds (66.7%) of patients were persons less than 40 years of age; 87.5% were males; 16.7% were admitted with Glasgow Coma Score (GCS) scores between 13 and 15; 37.5% were admitted with GCS between 9 and 12; 42.9% had asymmetric pupils; 33.3% were admitted because of traffic accidents; 21.7% were Marshall II, 65.2% were Marshall III, and 13.0% were Marshall IV. Conclusions: Our results suggest that characteristics associated to decompressive craniectomy because of head trauma contribute for its proper management.