Analysis of Complications Following Decompressive Craniectomy for Traumatic Brain Injury
Journal of Korean Neurosurgical Society
; : 244-250, 2010.
Article
em En
| WPRIM
| ID: wpr-214809
Biblioteca responsável:
WPRO
ABSTRACT
OBJECTIVE:
Adequate management of increased intracranial pressure (ICP) is critical in patients with traumatic brain injury (TBI), and decompressive craniectomy is widely used to treat refractory increased ICP. The authors reviewed and analyzed complications following decompressive craniectomy for the management of TBI.METHODS:
A total of 89 consecutive patients who underwent decompressive craniectomy for TBI between February 2004 and February 2009 were reviewed retrospectively. Incidence rates of complications secondary to decompressive craniectomy were determined, and analyses were performed to identify clinical factors associated with the development of complications and the poor outcome.RESULTS:
Complications secondary to decompressive craniectomy occurred in 48 of the 89 (53.9%) patients. Furthermore, these complications occurred in a sequential fashion at specific times after surgical intervention; cerebral contusion expansion (2.2 +/- 1.2 days), newly appearing subdural or epidural hematoma contralateral to the craniectomy defect (1.5 +/- 0.9 days), epilepsy (2.7 +/- 1.5 days), cerebrospinal fluid leakage through the scalp incision (7.0 +/- 4.2 days), and external cerebral herniation (5.5 +/- 3.3 days). Subdural effusion (10.8 +/- 5.2 days) and postoperative infection (9.8 +/- 3.1 days) developed between one and four weeks postoperatively. Trephined and post-traumatic hydrocephalus syndromes developed after one month postoperatively (at 79.5 +/- 23.6 and 49.2 +/- 14.1 days, respectively).CONCLUSION:
A poor GCS score ( or = 65 were found to be related to the occurrence of one of the above-mentioned complications. These results should help neurosurgeons anticipate these complications, to adopt management strategies that reduce the risks of complications, and to improve clinical outcomes.Palavras-chave
Texto completo:
1
Base de dados:
WPRIM
Assunto principal:
Couro Cabeludo
/
Derrame Subdural
/
Lesões Encefálicas
/
Pressão Intracraniana
/
Incidência
/
Estudos Retrospectivos
/
Contusões
/
Epilepsia
/
Craniectomia Descompressiva
/
Hematoma
Tipo de estudo:
Incidence_studies
/
Observational_studies
/
Prognostic_studies
Limite:
Humans
Idioma:
En
Ano de publicação:
2010
Tipo de documento:
Article