Decompressive craniectomy in traumatic brain injury: A single-center, multivariate analysis of 1,236 patients at a tertiary care hospital in India

2015 ◽  
Vol 63 (2) ◽  
pp. 175 ◽  
Author(s):  
Sumit Sinha ◽  
Amol Raheja ◽  
GuruD Satyarthee ◽  
PankajK Singh ◽  
Vivek Tandon ◽  
...  
2021 ◽  
Vol 10 (10) ◽  
pp. 711-714
Author(s):  
Khongbantabam Vyas ◽  
Khaidem Mani Singh

BACKGROUND Cranioplasty although a simple elective neurosurgical procedure is burdened by considerable morbidity. The timing of doing cranioplasty and a good outcome remains a topic of much debate. We wanted to compare the outcome of doing cranioplasty within (early) and beyond (late) 2 months after decompressive craniectomy for traumatic brain injury. METHODS The study was carried out in a tertiary care hospital. A 5-year retrospective study of patient records was analysed. Consecutive series of traumatic brain injury patients who underwent cranioplasty after decompressive craniectomy from a tertiary care hospital operated by a single neurosurgeon, were studied. Data was analysed using SPSS version 21, IBM. Associations of categorical variables were compared using chisquare test and of continuous variables by using unpaired 2-tailed Student t-test. RESULTS Altogether 90 patients were identified who had undergone cranioplasty after decompressive craniectomy for traumatic brain injury and were grouped into early (within 2 months; 44 patients) and late (beyond 2 months; 46 patients). Cranioplasty operative time was significantly shorter in the early (59.39 mins) than the late (77.28 mins) with a P value of 0.001. Infection rates were significantly higher in the early (4.55 %) than late (0 %), with P value 0.144. Other complication rates were postoperative haematoma (0 % early, 2.17 % late, P = 0.325), hydrocephalus (0 % early, 6.52 % late, P = 0.085), sunken brain (0 % early, 4.35 % late, P = 0.162), and bone graft resorption (0 % early, 2.17 % late, P = 0.325). These differences were not statistically significant though. CONCLUSIONS Early cranioplasty performed within 2 months of decompressive craniectomy has better outcome in the form of reduced hospital stay, decreased cost, and fewer complications. KEY WORDS Traumatic Brain Injury, Decompressive Craniectomy, Outcome, Cranioplasty


Neurosurgery ◽  
2018 ◽  
Vol 84 (1) ◽  
pp. 95-103 ◽  
Author(s):  
Silvia D Vaca ◽  
Benjamin J Kuo ◽  
Joao Ricardo Nickenig Vissoci ◽  
Catherine A Staton ◽  
Linda W Xu ◽  
...  

2020 ◽  
Vol 27 (01) ◽  
pp. 94-99
Author(s):  
Qazi Muhammad Zeeshan ◽  
Ramesh Kumar ◽  
Asim Rehmani ◽  
Muhammad Imran ◽  
Atiq Ahmed Khan ◽  
...  

Objectives: Our study aims to determine the frequency of progressive hemorrhagic injury as observed on the CT scan from the initial scan performed at the time of presentation to a subsequent one in the 12 hours after the initial scan. Study Design: The type of study is a prospective observational case series. Setting: At Tertiary Care Hospital in Karachi, Pakistan. Period: 3 months from June 2018 to August 2018. Materials & Methods: All patients over 18 years of age who presented to the Accident and Emergency Department of the hospital with traumatic brain injury and had a CT scan performed within four hours of the injury were included in the study. A predesigned proforma was used to note down patient findings. CT scan findings were classified as subdural hematoma (SDH), intraparenchymal contusion (IPC) extradural hematoma (EDH) and subarachnoid hemorrhage (SAH). A repeat CT scan was performed twelve hours after the initial CT scan. Data were analyzed using IBM SPSS version 20.0, mean and frequencies were calculated for continuous variables while frequencies and percentages were calculated for categorical variables. Results: Of the n= 110 patients in our study 79 were males and 31 were female, the mean age of the patients was 34.25 years. The Glasgow Coma Scale scores at the time of arrival were between thirteen and fifteen for n= 33 (30%) of the patients, between nine and twelve for n= 54 (49.09%) of the patients, less than and equal to eight for n= 23 (20.90%) of the patients. Subarachnoid hemorrhage was present in n= 32 (29.09%) patients, intraparenchymal hematoma was present in n= 42 (38.18%) of the patients, while subdural hematoma and epidural hematoma was present in n= 14 (12.72%) and n= 22 (20%) of the patients respectively. Progressive hemorrhagic injury was found in n= 66 (60%) of the patients, while in n= 11 (10%) of the patients there was resolution of the lesion and n= 33 (33%) of the patients showed no observable changes in the repeat CT scan. Finally, our results indicate that of the 110 patients in our study PHI was seen in n= 17 (53.12%) patients with SAH, n= 18 (81.81%) patients of EDH, n= 5 (35.71%) patients of SDH and n= 26 (61.90%) patients of IPC respectively. Conclusion: According to the results of our study PHI is observed in 60% of the patients with a traumatic brain injury observed within the initial 12 hours after injury, and epidural hematoma and intraparenchymal contusions had the highest incidences of PHI among all the different types of traumatic brain injuries.


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