RESUMO
A preliminary study on the intraoperative reversal of transtentorial herniation with traumatic brain injury Abstract objective To explore the advantages of the directive reversal of transtentorial herniation without incising tentorium of cerebellum in the operation on traumatic brain injury. Methods One hundred eighty-four cases of traumatic brain injuries with transtentorial herniation were collected. All the cases were operated by transfrontal-temporal-parietal approach. The cerebral hemorrhage and the focuses of contusion and laceration were cleared thoroughly. Additionally, a group of 68 cases of transtentorial herniation were reversed directly under microscope, keeping the tentorium of cerebellum contact in the surgery. The computed tomography appearance, the improvement of mind and mydriasis, intracranial pressure and surgical complications such as brain infarction, hydrocephalus were compared between the two group postoperatively. Results The statistic result indicates that the computed tomography appearances, the improvement of mind and mydriasis, intracranial pressure and surgical complications of the group of intraoperative reversal is superior to the group of non-reversal. Conclusion The directive reversal of transtentorial herniation without incising tentorium of cerebellum in the operation on traumatic brain injury is superior to the control group. Keywords Traumatic brain injury; transtentorial herniation; operation; reserval appearance, the improvement of mind and mydriasis, intracranial pressure and surgical complications such as brain infarction, hydrocephalus were compared between the two group postoperatively. Results The statistic result indicates that the computed tomography appearances, the improvement of mind and mydriasis, intracranial pressure and surgical complications of the group of intraoperative reversal is superior to the group of non-reversal. Conclusion The directive reversal of transtentorial herniation without incising tentorium of cerebellum in the operation on traumatic brain injury is superior to the control group.