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IrJNS 2017, 3(1): 17-20 Back to browse issues page
Decompressive Craniectomy in Traumatic Brain Injury:Factors Influencing Prognosis and Outcome
Dr Seyed reza Bagheri1, Dr Ehsan Alimohammadi *2, Dr Hamidreza Saeedi3, Dr Parandoosh Sepehri1, Dr Pezhman Soleimani1, Dr Reza Fatahian1, Dr Alireza Abdi4, Dr Omid Beiki4
1- assistant professor of neurosurgery assistant professor of neurosurgery, Kermanshah University Of Medical Science, Kermanshah, IRAN
2- resident of neurosurgery assistant professor of neurosurgery, Kermanshah University Of Medical Science, Kermanshah, IRAN , hafez125@gmail.com
3- associate professor of neurosurgery assistant professor of neurosurgery, Kermanshah University Of Medical Science, Kermanshah, IRAN
4- assistant professor of neurosurgery, Kermanshah University Of Medical Science, Kermanshah, IRAN
Abstract:   (422 Views)

Background and Aim: Decompressive craniectomy (DC) can be life-saving for patients with severe traumatic brain injury (TBI), but
many questions about its ideal application, indications, timing, technique, and even the definition of success of DC remains unclear.
The aim of this study was to assess the factors associated with prognosis and outcome of patients with TBI who had undergone a rapid
decompressive craniectomy.
Methods and Materials/Patients: We investigated 61 patients, who had underwent rapid decompressive craniectomy. The effect of
variables including demographic features of patients, primary level of consciousness, pupil size and reactivity, midline shift in patients
brain CT scan on outcome of patients were assessed.
Results: Sixty-one patients (36 males and 25 females) underwent rapid surgical DC within 4.5 ± 2 hours after trauma. Mean age of patients
was 36.09± 15.89 years old (range 16 to 68). Of 61 patients, 33 (54.1%) had favorable and 28 (45.9%) had unfavorable outcome. Patients
with following conditions had significantly worse outcome; older than 60 years, bilateral non-reactive mydriasis, critical head injury
(GCS<5), more than 10 millimeters of midline shift in their brain CT scan. GCS and age could predict the outcome of surgery significantly
of other variables. So that higher age predicted unfavorable outcome with 1.13 times, and in GCS<5 the probability of unfavorable
outcome is about 192 times. Patients with midline shift > 10 mm had 6.15 times more risk of unfavorable outcome compared to those with
lower than 10 mm of midline shift.
Conclusion: In this study we found that age more than sixty years and GCS less than five were associated with poor outcome. Patients
with these conditions could not benefit much from early DC.

Keywords: Decompressive Craniectomy, Glasgow Outcome Scale, Glasgow Coma Scale
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Type of Study: Research | Subject: Special
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Bagheri S R, Alimohammadi E, Saeedi H, Sepehri P, Soleimani P, Fatahian R, et al . Decompressive Craniectomy in Traumatic Brain Injury:Factors Influencing Prognosis and Outcome. IrJNS. 2017; 3 (1) :17-20
URL: http://irjns.org/article-1-70-en.html
Volume 3, Number 1 (I 2017) Back to browse issues page
مجله جراحی مغز و اعصاب ایران Iranian Journal of Neurosurgery
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