Standard large trauma craniotomy for severe traumatic brain injury.
- Author:
Li-quan LÜ
1
;
Ji-yao JIANG
;
Ming-kun YU
;
Li-jun HOU
;
Zhi-gang CHEN
;
Guang-ji ZHANG
;
Cheng ZHU
Author Information
- Publication Type:Clinical Trial
- MeSH: Adult; Brain Injuries; mortality; surgery; Chi-Square Distribution; Craniotomy; standards; Female; Glasgow Coma Scale; Humans; Intraoperative Complications; Male; Middle Aged; Postoperative Complications; Treatment Outcome
- From: Chinese Journal of Traumatology 2003;6(5):302-304
- CountryChina
- Language:English
-
Abstract:
OBJECTIVETo study the effect of standard large trauma craniotomy (SLTC) on outcomes of patients with severe traumatic brain injury (TBI) (GCS<=8).
METHODS230 patients with severe TBI were randomly divided into two groups. 115 patients underwent SLTC (10 cm x 12 cm) as an SLTC group, and other 115 patients underwent temporo-parietal or fronto-temporal craniotomy (6 cm x 8 cm) according to the position of hematomas as a routine craniotomy (RC) group. Other treatments were identical in two groups. According to Glasgow outcome scale (GOS), the prognosis of the patients was evaluated and the complications were compared between two groups.
RESULTS27 patients got good outcome and moderate disability (23.5%), 40 severe disability and vegetative survival (34.8%), and 48 died (41.7%) in SLTC group. 21 patients got good outcome and moderate disability (18.3%), 28 severe disability and vegetative survival (24.3%), and 66 died (57.4%) in RC group. The incidence of incision hernia was lower in SLTC group than in RC group. However, the incidence of operative encephalocele, traumatic epilepsy and intracranial infection were not different in two groups.
CONCLUSIONSStandard large trauma craniotomy significantly reduces the mortality of patients with severe TBI without serious complications, but does not improve the life quality of the patients.
