Study on the Treatment Results of Decompressive Craniectomy in Severe Traumatic Brain Injury Without Mass Lesion

Abstract

Objectives: To evaluate the treatment results of severe traumatic brain injury without intracranial hematoma by decompressive craniectomy. Methods: An uncontrolled intervention study on 45 patients with severe traumatic brain injury, no intracranial hematoma, high intracranial pressure above 20 mmHg, unresponsive to medical therapy, and operated decompressive craniectomy at Viet Duc University Hospital from May 2017 to December 2022. Research variables: Age, gender, cause of the accident, preoperative GCS, pulse and blood pressure before surgery, and CT images before and 3 months after surgery. Comparing treatment results between groups. Results: 45 patients were studied, including 42 males and 3 females; the oldest age was 78, and the lowest was 6 years old; traffic accidents accounted for the majority of 86.7%; daily-life accidents was 8.9%; GCS before surgery: 3 - 5 points (55.6%), GCS: 6 - 8 points (44.4%); GCS = 8 points (8.9%). The mean ICP was: 40.09 ± 10.37 mmHg. Results when patients were discharged: 9 patients were dead and 36 patients were alive. Conclusion: In the treatment results of decompression craniectomy on patients with a severe traumatic brain injury without intracranial hematoma, the mortality rate, vegetative state, and severe sequelae are still high.