Emergent burr hole drainage followed by decompressive craniotomy improves the clinical outcome of traumatic intracerebral haematoma-induced cerebral hernia
10.3760/cma.j.issn.1671-8925.2012.09.011
- VernacularTitle:锥、钻颅引流减压抢救急性硬膜外(下)血肿致脑疝患者的临床研究
- Author:
Lian-Shui HU
1
;
Ming-Sheng ZHANG
;
Wen-Hao WANG
;
Yi-Gang YU
;
Jun-Ming LIN
;
Wei HUANG
;
Fei LUO
;
Yuan ZHANG
;
Long ZHOU
Author Information
1. 解放军第一七五医院(厦门大学附属东南医院)
- Keywords:
Epidural hematoma;
Subdural hematoma;
Brain hernia;
Burr-hole;
Craniotomy
- From:
Chinese Journal of Neuromedicine
2012;11(9):908-911
- CountryChina
- Language:Chinese
-
Abstract:
Objective To investigate the clinical benefits of emergent burr hole drainage in combination with decompressive craniotomy for patients with traumatic intracerebral haematoma-induced cerebral hernia. Methods A total of 291 patients with brain hernia caused by acute traumatic epidural and/or subdural hematoma were chosen in our study; 143 of them were treated with decompressive craniotomy alone (ordinary decompression group, admitted to our hospital from January 2003 to December 2006) and 148 of them were treated with emergent burr hole drainage in combination with decompressive craniotomy (emergent surgical intervention group,admitted to our hospital from January 2007 to June 2011).Clinical parameters,including Glasgow Outcome Scale (GOS) scores,incidence of massive cerebral infarction,pupil retraction rate,and Glasgow Coma Scale (GCS) scores,were evaluated retrospectively analyzed. Results Patients in ordinary decompression group had higher GOS scores than those in emergent surgical intervention group (Z=-4.012,P=0.000); mean rank indicated that the treatment efficacy in the emergent surgical intervention group was better than that in the other group.Patients in ordinary decompression group had significantly reduced incidence of massive cerebral infarction (45/148) as compared with patients in ordinary decompression group (70/143,P=0.000).Much more patients (124/148) enjoyed increment of GCS scores in the emergent surgical intervention group as compared with those in the ordinary decompression group (65/143,P=0.000). Conclusion Emergent burr hole drainage followed by decompressive craniotomy is an effective method in saving patients with brain hernia caused by acute traumatic intracerebral haematoma, which can notably resolve intracranial hypertension as soon as possible and give longer time for surgery,therefore,it can improve the prognosis.
