Clinical analysis of extensive cerebral infarction following surgery for severe head injury
10.3760/cma.j.issn.1671-8925.2009.07.022
- VernacularTitle:重型颅脑损伤术后大面积脑梗死临床分析
- Author:
Hai-Qing WU
1
;
Jing-Dong LI
;
Sheng-Qing WU
;
Zhen-Kun ZENG
Author Information
1. 广东省东莞市石碣医院
- Keywords:
Craniocerebral trauma;
Cerebral infarction;
Complication
- From:
Chinese Journal of Neuromedicine
2009;8(7):731-733
- CountryChina
- Language:Chinese
-
Abstract:
Objective To analyze the factors related to the occurrence of extensive cerebral infarction following surgeries for severe head injury and analyze the clinical outcomes of the patients. Methods Twenty patients with extensive cerebral infarction following surgeries for severe head injury were retrospectively analyzed for preoperative Glasgow Coma Scale (GCS) scores, hemorrhage volume, skull base fracture, pupil size, presence and duration of cerebral hernia. All the patients were treated with standard large bone flap decompression and/or routine comprehensive treatments. Results Patients with preoperative GCS score less than 5, intraeranial hemorrhage over 60 mL, and skull base factures complicated by prolonged cerebral hernia had significantly increased incidence of cerebral infarction. The 20 patients were followed up for 12 months and their clinical outcomes were evaluated with Glasgow Outcome Scale (GOS), which showed good recovery in 8 cases, moderate disability in 3 cases, severe disability in 2 cases, and vegetative survival in 3 cases. Death occurred in 4 cases. Conclusion Multiple factors may contribute to extensive cerebral infarction following surgery for severe head injury, among which low preoperative GCS score, massive intracranial hemorrhage, and prolonged skull base fracture with cerebral hernia are highly risk factors. Early detection of the infarction and timely management with decompression, dehydration, intracranial pressure control, promoting brain circulation, prevention of cerebral vasospasm, and mild hypothermia treatment may help lower the disability and mortality rates of the patients.
