Outcome of decompressive craniectomy for traumatic brain injury: An institutional-based analysis from Nepal

Shah, Damber Bikram; Paudel, Prajwal; Joshi, Sumit; Karki, Prasanna; Sharma, Gopal Raman

doi:10.4103/ajns.ajns_392_20

Cited by 11 publications

(19 citation statements)

References 25 publications

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“…In this study found majority were male (94.1%) and only 5.9% were female. These findings are well agreement with other studies Silva et al 2 Similar study Shah et al 13 reported 33 (71.7%) were male and 13 (28.3%) were female.…”

Section: Discussionsupporting

confidence: 92%

Retrospective Review of Bilateral Decompressive Craniectomy of 51 Patients after Severe Traumatic Head Injury

Karim¹,

Habib²,

Monsur³

et al. 2022

Bangla J. Neurosurgery

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Background: Decompressive craniectomy (DC) is one of the commonly used treatment modalities for refractory intracranial hypertension after severe traumatic brain injury. Objective: To assess the functional outcome following bilateral decompressive craniectomy (DC) in traumatic head injury based on Glasgow Outcome Scale (GOS). Materials and methods: This is a retrospective study conducted at Enam Medical College & Hospital, from January 2019- December 2020. Data of the patients who had undergone bilateral DC for severe traumatic head injury were reviewed from medical record files. Data were collected pre-designed data collection sheet. Data were analyzed using computer based program statistical package for social science (SPSS) for windows version 25.0 software. Results: This study shows maximum (56.9%) were 16-30 years. The average age was 29.70±14.78 years. Majority were male (94.1%) and only 5.9% were female. Road traffic accidents (RTA) were the most frequent causative event of traumatic injury. Most of the patients (88.2%) were hospital stay 1-5 days then 9.8% were 6-10 days and only 2% were >10 days. The average hospital stays were 3.26±2.43 days. Majority (60.7%) were good recovery, 13.7% were moderate disability, 5.9% were severe disability, 2% were persistent vegetative state and 13.7% were death at home. Conclusion: This study recommends a larger prospective study to assess the longterm functional outcome of bilateral decompressive craniectomy after severe traumatic head injury. Bang. J Neurosurgery 2022; 11(2): 89-93

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Section: Discussionsupporting

confidence: 92%

Retrospective Review of Bilateral Decompressive Craniectomy of 51 Patients after Severe Traumatic Head Injury

Karim¹,

Habib²,

Monsur³

et al. 2022

Bangla J. Neurosurgery

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“…This study was carried out to find on decompressive single stage bilateral craniotomy in case of patients suffering from traumatic brain injury. Irrespective of the fact that there is a lot of research going to find the pharmacological treatments related to traumatic brain injury but still it is a major health dilemma for people worldwide [12][13] . In order to standardize the surgical techniques and indications, there is a lot of study going on.…”

Section: Discussionmentioning

confidence: 99%

Evaluation of the Efficacy of the Non-Decompressive Single Stage Bilateral Craniotomy in Treatment of Traumatic Brain Injury

uallah¹,

Khan²,

Zubair³

et al. 2022

PJMHS

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Background: Traumatic brain injury is one of the major health care problem around the globe. It is heterogeneous entity. Traumatic lesions including fracture and hematomas typically require surgery. Objective: The study aimed to analyze the Non-Decompressive Single Stage Bilateral Craniotomy in the patients suffering from traumatic brain injury. Study design: This prospective and single center based study was conducted at the neuroscience department of Prime Teaching Hospital/ Peshawar Medical College for the duration of the six months from January 2022 to June 2022. Material and Methods: Out of all the patients visited the neuroscience department of our institute teaching hospital, only 40 were selected for the study after analysis of the computed tomography images. These 40 fulfilled the inclusion criteria. The ethical and review board committee of our hospital approved the study. The patients willingly signed the consent. The bilateral frontal contusectomy was most commonly used surgical procedure. While other used surgical procedures were contralateral contusion and unilateral epidural hematoma. Results: Out of all the patients admitted in the hospital there were 40 that met all the requirements of the study. There were 30 men and 10 women. Most of the cases were reported in the range of 40-59 age. Middle aged men were mostly effected by the disease. The cases were almost in equal number as far as severity of the Traumatic brain injury is concerned. There were some patients that developed ventilator acquired pneumonia and some of the participants suffered from urinary tract infection along with a case of wound infection. There were some death cases reported as well. There were some of the patients who quit medical advice because of their poor financial state. Conclusion: To deal with traumatic brain injury in an effective way, SSBC can prove to be a safe and cost effective procedure, as it has multiple advantages like single incision, single anesthesia and reduced surgical charges, the management of the patient after operation is similar to that of unilateral procedure. Stay in hospital is also reduced and opposite lesion condition can also be avoided this way. Keywords: Traumatic brain, injury, surgical treatment and unilateral procedures.

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“…The outcome of TBI is brain oedema, increased ICP, reduced blood supply, reduced oxygen delivery to brain cells, and cell death. Therefore, the critical element in the management of severe head injury patients is to prevent secondary insult to brain cells, reduce brain oedema and ICP, and maintain blood, oxygen, and energy supply to the brain cells [5].…”

Section: Introductionmentioning

confidence: 99%

Role of Decompressive Craniectomy/ Hemicraniectomy in the Management of Traumatic Brain Injury: A Retrospective Study

Singh¹,

Maheshwari²,

Surendran³

et al. 2023

IJARS

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Introduction: Head injury is one of the most common outcomes of any kind of trauma becoming the major cause of morbidity and mortality worldwide. The critical element in the treatment of patients with severe head injuries is to prevent the progression of the condition and secondary insult to brain cells. Various protocols are followed for the treatment of severe head injury starting from conservative medical management to surgical approaches like DC/hemicraniectomy (DC). The DC is a surgical method of removal of part of skull bone so that the brain parenchyma gets space to expand and the Intracranial Pressure (ICP) can get reduced. There are various factors that contribute to the outcome of DC. Aim: To determine the various factors that affect the outcome of DC/hemicraniectomy. Materials and Methods: A retrospective descriptive study was conducted in the Institute of Gandhi Medical College and associated Hamidia hospital, Madhya Pradesh, India from May 2017 to April 2021. Hundred patients with moderate to severe head injury who underwent primary DC were included in this study. The variables such as age, preoperative GCS, the timing of surgery, preoperative pupillary reaction, and MidLine Shift (MLS) were compared in terms of survival/death and favourable/ unfavourable outcomes using the chi-square test. Results: The mean age of participants was 45±14 years. Statistical analysis showed significant results for the variables like age, preoperative the Glasgow Coma Scale (GCS), timing of the surgery, pupillary reaction at presentation, and preoperative MLS in terms of survival/death and favourable/ unfavourable outcomes. Conclusion: Younger age group, better preoperative GCS, early surgery, reactive pupils at presentation, and less preoperative MLS have positive outcome benefits with the DC/ hemicraniectomy to reduce the raised ICP.

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Outcome of decompressive craniectomy for traumatic brain injury: An institutional-based analysis from Nepal

Cited by 11 publications

References 25 publications

Retrospective Review of Bilateral Decompressive Craniectomy of 51 Patients after Severe Traumatic Head Injury

Retrospective Review of Bilateral Decompressive Craniectomy of 51 Patients after Severe Traumatic Head Injury

Evaluation of the Efficacy of the Non-Decompressive Single Stage Bilateral Craniotomy in Treatment of Traumatic Brain Injury

Role of Decompressive Craniectomy/ Hemicraniectomy in the Management of Traumatic Brain Injury: A Retrospective Study

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