ABSTRACT
To find the outcome of bifrontal decompression craniotomy [DC] for the treatment of traumatic bifrontal contusions. Descriptive case series. Department of Neurosurgery Jinnah Postgraduate Medical Center [JPMC] Karachi, from January 2011 to March 2014. This study included patients with bifrontal contusions secondary to trauma admitted through A and E department, aged between 14 year to 60 year with confirmation on CT scan having Glasgow Coma Scale [GCS] scores between 6-12. Patients who were unfit for surgery or anesthesia and those with coagulation disorders, were excluded. Patients underwent bifrontal DC with evacuation of contusions followed by duraplasty. The age, gender, preoperative size of the contusion, GCS on admission, postoperative complications and Glasgow Outcome Scale [GOS] score after 6 months of surgery were recorded. This study was conducted on 50 patients. Trauma was the commonest type of injury in 43 [86%] cases. Mostly patients were males [84%]. Majority of patients were between 21 year and 40 year of age. The GCS score before surgery in these patients was 9 in 13 [26%] patients, 10 in 16 [32%] patients, 11 in 11 [22%] patients, 12 in 6 [12%] and 13 in 4 [8%] patients. The most common size of contusions was 4 and 5 cms, both on right and left side. Of these, none of the patients required reoperation. Three died after aspiration within the postoperative time span of day 5-7. Good recovery was seen in 40 [80%] patients, moderate disability in 6[12%], severe disability in 1 [2%], persistent vegetative state in 2 [4%] and death in 1 [2%] patient. This study showed feasibility and efficacy of DC in bifrontal brain contusions secondary to traumatic brain injury [TBI] with good outcome