Comparative analysis of craniotomy methods in severe traumatic brain injury
Keywords:traumatic brain compression, subdural hematoma, epidural hematoma, intracerebral hematoma, burr hole surgery, craniectomy, osteoplastic craniotomy
The goal of research: to improve the results of neurosurgical management in patients with traumatic brain compression by detecting an optimal way of craniotomy.
Material and methods. The study includes data of 127 patients with traumatic brain compression. The series consisted of 109 (85.8 %) males and 18 (14.2 %) females out of examined. The patients’ age ranged from 16 to 85 years. The neurosurgical interventions were performed in all patients with traumatic brain compression.
Results. The patients with traumatic brain compression regardless of craniotomy method (burr hole surgery, craniectomy, osteoplastic craniotomy) did not experience a statistically significant difference in the outcome. When planning a method of craniotomy in traumatic brain compressio, the grade of consciousness impairment on the Glasgow coma scale, brain contusion foci, acute subdural and intracerebral hematomas, brain compression, patients’ age and brain dislocation syndrome should be considered that predicts an outcome.
Conclusion. The results of a burr hole, resection, and osteoplastic craniotomy revealed no significant differences in outcome in patients with traumatic brain injury. Resection craniotomy in traumatic brain injury may be effective enough even in deep coma and dislocation syndrome but in absence of intraoperative brain edema. The absence of brain edema, the moderate coma level are indications for osteoplastic craniotomy.
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