Application of expanding coronal decompressive craniectomy and sequential dural incision for treating patients with severe bilateral frontal contusion
10.3760/cma.j.issn.1673-4904.2012.14.005
- VernacularTitle:扩大冠状骨瓣减压和硬脑膜顺序剪开术治疗重型双侧额叶脑挫裂伤
- Author:
Youcheng LIN
;
Guofeng YAN
;
Hao YAO
;
Weipeng LU
;
Zhaozhi SU
;
Guorong DING
;
Ruihong HUANG
;
Lianfu XIAO
- Publication Type:Journal Article
- Keywords:
Frontal lobe;
Brain injuries;
Intracranial hemorrhage,traumatic;
Neurosurgical procedures
- From:
Chinese Journal of Postgraduates of Medicine
2012;35(14):14-16
- CountryChina
- Language:Chinese
-
Abstract:
ObjectiveTo explore the effect of combined usage of expanding coronal decompressive craniectomy and sequential dural incision for treating severe bilateral frontal contusion (SBFC).Methods Forty-three patients with SBFC were randomly divided by sequential single day after hospitalization into two groups.Observation group(23 cases) treated with expanding coronal decompressive craniectomy and sequential dural incision.Control group (20 cases) treated with standard hemicraniectomy and routine dural incision.ResultsThe occurrence rate of acute cephalocele was significantly lower in observation group [ 17.4％(4/23) ] than that in control group [ 55.0％(11/20) ] (P ＜ 0.05).According to Glasgow outcome scale (GOS) score of six-month observation after operation,17 cases(73.9％,17/23) of observation group got favourable recovery or moderate deficit,other 6 cases(26.1％,6/23) got severe deficit,persistent vegetative status or death.While only 8 cases(40.0％,8/20) got favourable recovery or moderate deficit,12 cases ( 60.0％,12/20 ) got severe deficit,persistent vegetative status or death in control group.The rate of favourable recovery and moderate deficit of two groups had statistical significance (P ＜ 0.05).ConclusionCombination application of expanding coronal decompressive craniectomy and sequential dural incision is an effective method to treat patients with SBFC,and can obviously improve the rate of successful rescue and decrease the rate of mortality and disability.
