Craniotomy or Decompressive Craniectomy for Acute Subdural Hematomas: Surgical Selection and Clinical Outcome / 대한신경손상학회지
Korean Journal of Neurotrauma
;
: 22-27, 2016.
Artigo
em Inglês
| WPRIM
| ID: wpr-167780
ABSTRACT
OBJECTIVE:
Craniotomy (CO) and decompressive craniectomy (DC) are two main surgical options for acute subdural hematomas (ASDH). However, optimal selection of surgical modality is unclear and decision may vary with surgeon's experience. To clarify this point, we analyzed preoperative findings and surgical outcome of patients with ASDH treated with CO or DC.METHODS:
From January 2010 to December 2014, data for 46 patients with ASDH who underwent CO or DC were retrospectively reviewed. The demographic, clinical, imaging and clinical outcomes were analyzed and statistically compared.RESULTS:
Twenty (43%) patients underwent CO and 26 (57%) patients received DC. In DC group, preoperative Glascow Coma Scale was lower (p=0.034), and more patient had non-reactive pupil (p=0.004). Computed tomography findings of DC group showed more frequent subarachnoid hemorrhage (p=0.003). Six month modified Rankin Scale showed favorable outcome in 60% of CO group and 23% of DC group (p=0.004). DC was done in patient with more unfavorable preoperative features (p=0.017). Patients with few unfavorable preoperative features (<6) had good outcome with CO (p<0.001).CONCLUSION:
In selective cases of few unfavorable clinical findings, CO may also be an effective surgical option for ASDH. Although DC remains to be standard of surgical modality for patients with poor clinical status, CO can be an alternative considering the possible complications of DC.
Texto completo:
DisponíveL
Índice:
WPRIM (Pacífico Ocidental)
Assunto principal:
Hemorragia Subaracnóidea
/
Pupila
/
Estudos Retrospectivos
/
Resultado do Tratamento
/
Coma
/
Craniotomia
/
Hematoma Subdural Agudo
/
Craniectomia Descompressiva
Tipo de estudo:
Estudo observacional
/
Estudo prognóstico
Limite:
Humanos
Idioma:
Inglês
Revista:
Korean Journal of Neurotrauma
Ano de publicação:
2016
Tipo de documento:
Artigo
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