Clinical observation on treatment of severe craniocerebral injury by decompressive craniotomy with bilateral integrated frontotemporal bone flap / 中华神经医学杂志

ABSTRACT

Objective To explore the value of decompressive craniotomy with bilateral integrated frontotemporal bone flap in treatment of severe craniocerebral injury.Methods Nineteen patients with severe craniocerebral injury,admitted to our hospital from September 2015 to February 2017,were chosen in our study.These patients were applied decompressive craniotomy with bilateral integrated frontotemporal bone flap.The clinical data and treatment efficacy were retrospectively analyzed.Results Contralateral brain tissues were detected in 2 patients with unilateral lesions during the operation due to brain tissue swelling,and no other patients were forced to close the skull because of malignant brain swelling.Within 10 d of surgery,the average fluctuation of intracranial pressure was about 20 mmHg.Three months after operation,Glasgow outcome scale (GOS) indicated 10 patients (52.6％) with good recovery,4 (21％) with mild disability,2 (10.5％) with severe disability,2 (10.5％) with plant survival,and one (5.26％) death.There were 4 with mild subdural effusion,and 3 of them got recovery after craniotomy.Five patients were complicated with epilepsy,2 with cerebrospinal fluid leakage and 3 with intracranial infection.Conclusion Decompressive craniotomy with bilateral integrated frontotemporal bone flap can achieve effective decompression,effectively prevent related complications,reduce damage of nerve function,and improve overall clinical prognosis at the same time for suitable cases.