Severe traumatic brain injury managed with decompressive craniectomy

Mezue, WC; Erechukwu, A U; Ndubuisi, Chika Anele; Ohaegbulam, SC; Chikani, Mark C

doi:10.4103/1119-3077.100654

Cited by 6 publications

(5 citation statements)

References 7 publications

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“…The best time to decompress a patient is still under discussion [7], but early DC (within 24 h after injury) is recommended for severely head injured patients without brain stem dysfunction requiring neurosurgery for removing intracranial collections [8]. Also, data suggested that complications of traumatic brain injury (TBI) may be reduced following early DC [9]- [12]. This decision can be made intraoperatively based on the patient's mechanism of injury, age, degree of underlying cerebral swelling, atrophy, or both; and the surgeon's estimation of the likelihood that the patient will develop severe ICH [13].…”

Section: Discussionmentioning

confidence: 99%

Decompressive Craniectomy in Traumatic Brain Injuries. Indications and Limits

Tahrir

Laaidi

Baayoud

et al. 2021

EJMED

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Background: Decompressive craniectomy is a surgical technique proposed in the treatment of intracranial hypertension refractory to medical treatment and engaging the vital prognosis of patients. Materials and methods: We conducted a retrospective study about 41 cases of decompressive flap in the neurosurgery department of CHU ibn Rochd of Casablanca between 2015 and 2018. Aim: This study aims to discuss the management of intractable ICH in adults, focusing on the role of DC in patients with traumatic brain and identify the different indications, contraindications and complications. Results: The results show a clear male predominance with an average age of 40 years. The initial GCS >7 was in 63%, and <7 in 36% of cases, anisocoria was present in 65%. The most frequent indication for craniectomy is a neurological worsening. The type of craniectomy performed in the majority of cases is a hemi craniectomy in 92% of cases. Concerning the prognosis, we observed 32% of deaths and 68% of survivors of which 39% of patients without sequelae GOS 5 and 32% with a moderate disability GOS 4. The moderate disability GOS 3 was found in 21% and one case in vegetative state GOS 2. Regarding immediate complications after craniectomy: 33% of patients presented convulsions, 12% a new homolateral hematoma, 49% a nosocomial pneumopathy and 10% a postoperative meningitis. Conclusion: Decisions to recommend DC must always be made not only in the context of its clinical indications but also after consideration of an individual patient's preferences and quality of life expectations.

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Section: Discussionmentioning

confidence: 99%

Decompressive Craniectomy in Traumatic Brain Injuries. Indications and Limits

Tahrir

Laaidi

Baayoud

et al. 2021

EJMED

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“…The study of Adeleye 10 comprised of patients with age ranged 23 to 78 years. The study of Mezue et al 11 comprised of patients with age ranged 15 to 80 years. The present study enrolled 60 patients into two groups.…”

Section: Discussionmentioning

confidence: 99%

Severe Head Injury Management at a Tertiary Care Hospital in Dhaka City

Haque

Ahmed

Haque³

et al. 2020

J. Natl Inst. Neurosci Bangladesh

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Background: Severe traumatic brain injury can be a serious condition. Objective: The purpose of the present study was to see the decompressive craniectomy (DC) of severe traumatic brain injury. Methodology: This clinical trial was conducted in the Department of Neurosurgery at Dhaka Medical College Hospital, Dhaka, Bangladesh from January 2012 to December 2013 for a period of two (02) years. Patients with the age of 18 years and above, GCS of the patients 8 to 4, severe traumatic brain injury (TBI) with multiple hemorrhagic contusions and midline shift, on CT scan and severe TBI with gradual neurological deterioration were included for this study. Total 60 patients were included. Result: A total of 60 patients were included in this study. Almost two third 18 (60.0%) patients had favorable outcome (GOS 4 and 5) in group A and exactly two third 20(66.7%) patients had Unfavorable outcome (GOS 1,2 and 3) in group B (p<0.05). In this study 8 patient died among which 5 had GCS 4 and 3 had GCS 5. One patient with GCS 5 became persistent vegetative. Eight patient with good recovery had GCS 8, 7 and 6. Death occurred at mean GCS 9±2.mm of midline shift followed by 8± mm in persistent vegetative, 5.67±2.08 mm in severe disability, 4.5±2.88 mm in moderate disability and 3.38±1.06 mm in good recovery. Conclusion: Group A had better clinical outcome than group B. So based on statistical analysis it can be concluded that DC is preferable to conservative management in case of severe TBI. Journal of National Institute of Neurosciences Bangladesh, 2020;6(2): 124-128

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“…The best time to decompress a patient is still under discussion [3], but early DC (within 24 h after injury) is recommended for severely head-injured patients without brain stem dysfunction requiring neurosurgery for removing intracranial collections [4]. In addition, data suggested that complications of TBI might reduce following early DC [5,6]. At the end of the 20th century, the indications for DC were the following: ICP >30-35 mmHg or CPP < 45-70 mmHg, age <50 years, GCS >4, CT signs of brain swelling, associated masses, GCS 3 plus bilateral fixed pupils excluded [7][8][9].…”

Section: Time To Go To Decompressive Craniectomymentioning

confidence: 99%

Decompressive craniectomy in severe traumatic brain injuries: Indications, outcomes and the usefulness of transcranial doppler

Bankole¹,

Kouakou²,

Oudrhiri³

2022

J Clin Images Med Case Rep

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Background: The place of transcranial Doppler in the management of all severe traumatic brain injury remains today important in therapeutic decision-making. The decompressive craniectomy for him remains a little controversial. Objective: In a prospective series of patients with severe TBI, we aimed to determine the usefulness of TCD and the outcomes of severe TBI treated with decompressive craniectomy in a low-resource setting.

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Severe traumatic brain injury managed with decompressive craniectomy

Cited by 6 publications

References 7 publications

Decompressive Craniectomy in Traumatic Brain Injuries. Indications and Limits

Decompressive Craniectomy in Traumatic Brain Injuries. Indications and Limits

Severe Head Injury Management at a Tertiary Care Hospital in Dhaka City

Decompressive craniectomy in severe traumatic brain injuries: Indications, outcomes and the usefulness of transcranial doppler

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