https://scholars.lib.ntu.edu.tw/handle/123456789/479638
Title: | Decompressive craniectomy as the primary surgical intervention for hemorrhagic contusion | Authors: | ABEL PO-HAO HUANG YONG-KWANG TU Tsai Y.-H. Chen Y.-S. Hong W.-C. Yang C.-C. LU-TING KUO Su I.-C. Huang S.-H. Huang S.-J. |
Issue Date: | 2008 | Journal Volume: | 25 | Journal Issue: | 11 | Start page/Pages: | 1347-1354 | Source: | Journal of Neurotrauma | Abstract: | The standard surgical treatment of hemorrhagic cerebral contusion is craniotomy with evacuation of the focal lesion. We assessed the safety and feasibility of performing decompressive craniectomy and duraplasty as the primary surgical intervention in this group of patients. Fifty-four consecutive patients with Glasgow Coma Scale (GCS) scores of less than or equal to 8, a frontal or temporal hemorrhagic contusion greater than 20 cm3 in volume, and a midline shift of at least 5 mm or cisternal compression on computer tomography (CT) scan were studied. Sixteen (29.7%) underwent traditional craniotomy with hematoma evacuation, and 38 (70.4%) underwent craniectomy as the primary surgical treatment. Mortality, reoperation rate, Glasgow Outcome Scale-Extended (GOSE) scores, and length of stay in both the acute care and rehabilitation phase were compared between these two groups. Mortality (13.2% vs. 25.0%) and reoperation rate (7.9% vs. 37.5%) were lower in the craniectomy group, whereas the length of stay in both the acute care setting and the rehabilitation phase were similar between these two groups. The craniectomy group also had better GOSE score (5.55 vs. 3.56) at 6 months. Decompressive craniectomy is safe and effective as the primary surgical intervention for treatment of hemorrhagic contusion. This study also suggests that patient with hemorrhagic contusion can possibly have better outcome after craniectomy than other subgroup of patients with severe traumatic brain injury. ? 2008 Mary Ann Liebert, Inc. 2008. |
URI: | https://www.scopus.com/inward/record.uri?eid=2-s2.0-57349164283&doi=10.1089%2fneu.2008.0625&partnerID=40&md5=a0fa0cc3372a3d25c231d0aed564bc78 https://scholars.lib.ntu.edu.tw/handle/123456789/479638 |
ISSN: | 0897-7151 | DOI: | 10.1089/neu.2008.0625 | SDG/Keyword: | adult; aphasia; article; brain contusion; brain hemorrhage; computer assisted tomography; controlled study; craniectomy; craniotomy; emergency care; Glasgow coma scale; Glasgow outcome scale; head injury; human; intermethod comparison; intracranial pressure; length of stay; major clinical study; morbidity; mortality; postoperative complication; rehabilitation care; reoperation; risk assessment; Adult; Brain Hemorrhage, Traumatic; Brain Injuries; Cerebrovascular Circulation; Craniotomy; Debridement; Decompression, Surgical; Drainage; Dura Mater; Female; Glasgow Coma Scale; Humans; Intracranial Pressure; Intraoperative Care; Male; Middle Aged; Postoperative Care; Reoperation; Retrospective Studies; Tomography, X-Ray Computed; Treatment Outcome |
Appears in Collections: | 醫學系 |
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