STUDY ON THE TREATMENT RESULTS OF DECOMPRESSIVE CRANIECTOMY IN SEVERE TRAUMATIC BRAIN INJURY WITHOUT MASS LESION
Nội dung chính của bài viết
Tóm tắt
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.
Chi tiết bài viết
Từ khóa
Decompression craniectomy, Traumatic brain injury without intracranial hematoma, Intracranial pressure
Tài liệu tham khảo
2. Nguyen Van Hung. Research on clinical epidemiology and treatment attitude to closed traumatic brain injury caused by road traffic accidents at Viet Duc University Hospital in 2005. Graduation thesis as a secondary specialist. 2005. Hanoi Medical University. Interior.
3. Vu Ngoc Tu. Clinical features, computed tomography images and early results after treatment of severe traumatic brain injury at Viet Duc University Hospital. Graduation thesis as a resident doctor. 2004. Hanoi Medical University.
4. Tran Duy Anh. Active treatment of patients with severe traumatic brain injury. Medical Studies Military. 2003; 28:107-115.
5. Sahuquillo J, Arikan F. Decompressive craniectomy for the treatment of refractory high intracranial pressure in traumatic brain injury. Cochrane Database of Systematic Reviews. 2009; 25(1):CD003983.
6. Toussaint CP, Origitano TC. Decompressive Craniectomy: Review of Indication, Outcome, and Implication. Neurosurgery Quarterly. 2008; 18:45-53.
7. Yuan Q. Comparative study of decompressive craniectomy in traumatic brain injury with or without mass lesion. Br J Neurosurg. 2017; 41(2):213-225.
8. Daboussi A, Minville V, Leclerc - Foucras S, et al. Cerebral Hemodynamic changes in severe Head injury patients undergoing decompressive craniectomy. Journal of Neurosurgical Anesthesiology. 2009; 21:339-345.
9. Bor - Seng - Shu E, Figueiredo EG, Amorim RL, et al. Decompressive craniectomy: A meta - analysis of influences on intracranial pressure and cerebral perfusion pressure in the treatment of traumatic brain injury. Journal of Neurosurgery. 2012; 117:589-596.