Decompressive craniectomy in severe brain injury.
Zentralbl Neurochir
; 64(4): 171-7, 2003.
Article
in En
| MEDLINE
| ID: mdl-14634882
OBJECT: The goal of this study was to evaluate the therapeutic role of decompressive craniectomy in severe brain injury. METHODS AND RESULTS: Between 1996 and 1998 we treated 87 patients with severe brain injury (GCS 3-8) in our department. In 70 cases follow up data could be obtained. Mean age was 49 years (range 1-79). Initial CT scans of all patients demonstrated diffuse brain injury with generalised brain swelling and/or mass lesion. In 51 of these patients uni (n=40)- or bilateral (n=11) decompressive craniectomy was performed initially or secondarily after failure of standard treatment. In a retrospective analysis we performed statistical tests of the follow-up group. The mortality rate did not show a significant difference between the two treatment groups (p=0.802) with a slight advantage for the decompression. The log-rank-test demonstrated a non-significant improvement of the survival time for decompressed patients (p=0.632). Secondary decompression showed a significantly better survival rate and time compared to primary decompression. In all 7 pediatric cases (1-16 yrs) we performed craniectomy. 2 of them died immediately post emergency operation, 5 survived with good outcome (1 LOF). CONCLUSIONS: A slight, but non-significant benefit could be demonstrated after decompressive craniectomy in the whole patient population. In young patients decompression seems to have a more positive influence on outcome and survival.
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Collection:
01-internacional
Database:
MEDLINE
Main subject:
Brain Injuries
/
Decompression, Surgical
/
Neurosurgical Procedures
/
Craniotomy
Type of study:
Observational_studies
/
Prognostic_studies
Limits:
Adolescent
/
Adult
/
Aged
/
Child
/
Child, preschool
/
Female
/
Humans
/
Infant
/
Male
/
Middle aged
Language:
En
Journal:
Zentralbl Neurochir
Year:
2003
Document type:
Article
Affiliation country:
Alemania
Country of publication:
Alemania