Analysis of Complications Following Decompressive Craniectomy for Traumatic Brain Injury
Journal of Korean Neurosurgical Society
;
: 244-250, 2010.
Artigo
em Inglês
| WPRIM
| ID: wpr-214809
ABSTRACT
OBJECTIVE:
Adequate management of increased intracranial pressure (ICP) is critical in patients with traumatic brain injury (TBI), and decompressive craniectomy is widely used to treat refractory increased ICP. The authors reviewed and analyzed complications following decompressive craniectomy for the management of TBI.METHODS:
A total of 89 consecutive patients who underwent decompressive craniectomy for TBI between February 2004 and February 2009 were reviewed retrospectively. Incidence rates of complications secondary to decompressive craniectomy were determined, and analyses were performed to identify clinical factors associated with the development of complications and the poor outcome.RESULTS:
Complications secondary to decompressive craniectomy occurred in 48 of the 89 (53.9%) patients. Furthermore, these complications occurred in a sequential fashion at specific times after surgical intervention; cerebral contusion expansion (2.2 +/- 1.2 days), newly appearing subdural or epidural hematoma contralateral to the craniectomy defect (1.5 +/- 0.9 days), epilepsy (2.7 +/- 1.5 days), cerebrospinal fluid leakage through the scalp incision (7.0 +/- 4.2 days), and external cerebral herniation (5.5 +/- 3.3 days). Subdural effusion (10.8 +/- 5.2 days) and postoperative infection (9.8 +/- 3.1 days) developed between one and four weeks postoperatively. Trephined and post-traumatic hydrocephalus syndromes developed after one month postoperatively (at 79.5 +/- 23.6 and 49.2 +/- 14.1 days, respectively).CONCLUSION:
A poor GCS score ( or = 65 were found to be related to the occurrence of one of the above-mentioned complications. These results should help neurosurgeons anticipate these complications, to adopt management strategies that reduce the risks of complications, and to improve clinical outcomes.
Texto completo:
DisponíveL
Índice:
WPRIM (Pacífico Ocidental)
Assunto principal:
Couro Cabeludo
/
Derrame Subdural
/
Lesões Encefálicas
/
Pressão Intracraniana
/
Incidência
/
Estudos Retrospectivos
/
Contusões
/
Epilepsia
/
Craniectomia Descompressiva
/
Hematoma
Tipo de estudo:
Estudo de incidência
/
Estudo observacional
/
Estudo prognóstico
Limite:
Humanos
Idioma:
Inglês
Revista:
Journal of Korean Neurosurgical Society
Ano de publicação:
2010
Tipo de documento:
Artigo
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