Evaluation of prognostic factors of decompressive craniectomy in the treatment of severe traumatic brain injury
OBJECTIVE: to determine predictive factors for prognosis of decompressive craniectomy in patients with severe traumatic brain injury (TBI), describing epidemiological findings and the major complications of this procedure.METHODS: we conducted a retrospective study based on analysis of clinical and...
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Colégio Brasileiro de Cirurgiões
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ftjscielo:oai:scielo:S0100-69912014000400256 2023-05-15T16:02:03+02:00 Evaluation of prognostic factors of decompressive craniectomy in the treatment of severe traumatic brain injury Saade,Nelson Veiga,José Carlos Esteves Cannoni,Luiz Fernando Haddad,Luciano Araújo,João Luiz Vitorino 2014-08-01 text/html http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0100-69912014000400256 en eng Colégio Brasileiro de Cirurgiões Revista do Colégio Brasileiro de Cirurgiões v.41 n.4 2014 Decompressive craniectomy Intracranial hypertension/etiology Intracranial hypertension/surgery Brainedema/surgery Brain injuries/complications journal article 2014 ftjscielo 2015-10-26T18:33:36Z OBJECTIVE: to determine predictive factors for prognosis of decompressive craniectomy in patients with severe traumatic brain injury (TBI), describing epidemiological findings and the major complications of this procedure.METHODS: we conducted a retrospective study based on analysis of clinical and neurological outcome, using the extended Glasgow outcome in 56 consecutive patients diagnosed with severe TBI scale treated in the emergency department from February 2004 to July 2012. The variables assessed were age, mechanism of injury, presence of pupillary changes, Glasgow coma scale (GCS) score on admission, CT scan findings (volume, type and association of intracranial lesions, deviation from the midline structures and classification in the scale of Marshall and Rotterdam).RESULTS: we observed that 96.4% of patients underwent unilateral decompressive craniectomy (DC) with expansion duraplasty, and the remainder to bilateral DC, 53.6% of cases being on the right 42.9% on the left, and 3.6% bilaterally, with predominance of the fourth decade of life and males (83.9%). Complications were described as transcalvarial herniation (17.9%), increased volume of brain contusions (16.1%) higroma (16.1%), hydrocephalus (10.7%), swelling of the contralateral lesions (5.3%) and CSF leak (3.6%).CONCLUSION: among the factors studied, only the presence of mydriasis with absence of pupillary reflex, scoring 4 and 5 in the Glasgow Coma Scale, association of intracranial lesions and diversion of midline structures (DML) exceeding 15mm correlated statistically as predictors of poor prognosis. Article in Journal/Newspaper DML SciELO Brazil (Scientific Electronic Library Online) |
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Open Polar |
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SciELO Brazil (Scientific Electronic Library Online) |
op_collection_id |
ftjscielo |
language |
English |
topic |
Decompressive craniectomy Intracranial hypertension/etiology Intracranial hypertension/surgery Brainedema/surgery Brain injuries/complications |
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Decompressive craniectomy Intracranial hypertension/etiology Intracranial hypertension/surgery Brainedema/surgery Brain injuries/complications Saade,Nelson Veiga,José Carlos Esteves Cannoni,Luiz Fernando Haddad,Luciano Araújo,João Luiz Vitorino Evaluation of prognostic factors of decompressive craniectomy in the treatment of severe traumatic brain injury |
topic_facet |
Decompressive craniectomy Intracranial hypertension/etiology Intracranial hypertension/surgery Brainedema/surgery Brain injuries/complications |
description |
OBJECTIVE: to determine predictive factors for prognosis of decompressive craniectomy in patients with severe traumatic brain injury (TBI), describing epidemiological findings and the major complications of this procedure.METHODS: we conducted a retrospective study based on analysis of clinical and neurological outcome, using the extended Glasgow outcome in 56 consecutive patients diagnosed with severe TBI scale treated in the emergency department from February 2004 to July 2012. The variables assessed were age, mechanism of injury, presence of pupillary changes, Glasgow coma scale (GCS) score on admission, CT scan findings (volume, type and association of intracranial lesions, deviation from the midline structures and classification in the scale of Marshall and Rotterdam).RESULTS: we observed that 96.4% of patients underwent unilateral decompressive craniectomy (DC) with expansion duraplasty, and the remainder to bilateral DC, 53.6% of cases being on the right 42.9% on the left, and 3.6% bilaterally, with predominance of the fourth decade of life and males (83.9%). Complications were described as transcalvarial herniation (17.9%), increased volume of brain contusions (16.1%) higroma (16.1%), hydrocephalus (10.7%), swelling of the contralateral lesions (5.3%) and CSF leak (3.6%).CONCLUSION: among the factors studied, only the presence of mydriasis with absence of pupillary reflex, scoring 4 and 5 in the Glasgow Coma Scale, association of intracranial lesions and diversion of midline structures (DML) exceeding 15mm correlated statistically as predictors of poor prognosis. |
format |
Article in Journal/Newspaper |
author |
Saade,Nelson Veiga,José Carlos Esteves Cannoni,Luiz Fernando Haddad,Luciano Araújo,João Luiz Vitorino |
author_facet |
Saade,Nelson Veiga,José Carlos Esteves Cannoni,Luiz Fernando Haddad,Luciano Araújo,João Luiz Vitorino |
author_sort |
Saade,Nelson |
title |
Evaluation of prognostic factors of decompressive craniectomy in the treatment of severe traumatic brain injury |
title_short |
Evaluation of prognostic factors of decompressive craniectomy in the treatment of severe traumatic brain injury |
title_full |
Evaluation of prognostic factors of decompressive craniectomy in the treatment of severe traumatic brain injury |
title_fullStr |
Evaluation of prognostic factors of decompressive craniectomy in the treatment of severe traumatic brain injury |
title_full_unstemmed |
Evaluation of prognostic factors of decompressive craniectomy in the treatment of severe traumatic brain injury |
title_sort |
evaluation of prognostic factors of decompressive craniectomy in the treatment of severe traumatic brain injury |
publisher |
Colégio Brasileiro de Cirurgiões |
publishDate |
2014 |
url |
http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0100-69912014000400256 |
genre |
DML |
genre_facet |
DML |
op_source |
Revista do Colégio Brasileiro de Cirurgiões v.41 n.4 2014 |
_version_ |
1766397681853267968 |