Clinical analysis of standard large trauma craniotomy in treatment of acute subdural hematoma / 中国基层医药

Objective To explore the surgical techniques and clinical outcome of standard large trauma craniotomy in the treatment of acute subdural hematoma.Methods The clinical data of 51 cases with acute subdural hematoma,who underwent standard large trauma craniotomy in recent 5 years in our department,were retrospectively analyzed.Results All the patients were followed up for 3 ～ 6 months.10 cases were dead,4 persistent vegetative status,severe disability in 6 cases,midrange disability occurred in 11 cases and 20 cases were good.Postoperative complications included tardive haematoma in 4 cases,traumatic cerebral infarction in 2 cases,subdural collection of fluid in 4 cases,cerebromalacia in depressor area in 2 cases,hydrocephalus in 2 cases,and traumatic epilepsy in 3 cases.Conclusion Standard large trauma craniotomy is an effective approach in the treatment of acute subdural hematoma,due to its advantages such as satisfactory exposure for haemostasis,rapid removal of haematoma and relief of acute intracranial hypertension.

Standard large trauma craniotomy combining with moderate hypothermia in the emergency treatment of patients with severe head injuries / 临床外科杂志

Objective To evaluate the therapeutic efficacy of the method of standard large trauma craniotomy in combination with therapeutic moderate hypothermia.Method Patients with acute severe head injuries (GCS≤8)were assigned into two groups:Group I,30 cases(average GCS≤ 5.38) received standard large trauma craniotomy and moderate hypothermia for 5-7 days;Group Ⅱ,30 cases(average GCS≤5.46)were treated with traditional treatment as control.Mortality,GCS,GOS and intracranial pressure (ICP) were compared between these two groups.Result Both the GCS and GOS were higher in the group Ⅰ than group Ⅱ;while the mortality and ICP were obviously lower in the group Ⅰ than that of the control group.Conclusions Early standard large trauma craniotomy plus adequate decompression followed by postoperative therapeutic moderate hypothermia would be helpful in reducing the mortality moderate and morbidity of patients with severe head injuries,their level of living accommodation were improved as well.

Clinical study of standard large trauma craniotomy on frontotemporal and parietal contrecoup craniocerebral injury / 临床神经病学杂志

Objective To evaluate the value of standard large trauma craniotomy in frontotemporal and parietal contrecoup craniocerebral injury.Methods Forty-six patients with frontotemporal and parietal contrecoup craniocerebral injury were treated by standard large trauma craniotomy. Based on GOS, the clinical curative effect and complications of these patients during 3 to 6 months after operation were evaluated.Results 22 cases (47.83%) recovered well, 6 cases (13.04%) suffered from moderate disability, 4 cases (8.7%) remained severe disability, and 14 cases (30.43%) died. The common complications after operation were delayed intracranial hematoma, cerebral penetrating malformation, hydrocephalus, defect of skull syndrome and so on.Conclusion Standard large trauma craniotomy is a good therapeutic method for frontotemporal and parietal contrecoup craniocerebral injury.