Non Decompressive Single Stage Bilateral Craniotomy in Traumatic Brain Injury
Journal Title: Nepal Journal of Neuroscience - Year 2013, Vol 10, Issue 2
Abstract
Traumatic brain injury (TBI) is a heterogeneous entity that remains a major health-care problem worldwide. Surgery is usually indicated for traumatic lesions such as hematomas, fractures, or malignant cerebral edema. Most cases of surgery are unilateral with bilateral indication usually reserved for severe cerebral edema or bilateral hematoma. This is a prospective single center study of all cases that underwent Single stage bilateral cranioton (SSBC) from January 2010 to January 2013. Computed tomogram images of all TBI cases were analyzed and those cases that met the inclusion criteria were included. Out of all trauma cases there were 37 (4.6%) that met the inclusion criteria for SSBC. Males accounted for 33 (89%) of the total cases. There were almost equal numbers of cases in the mild, moderate and severe subtypes of TBI based on the initial GCS. The most common surgical procedures performed were bilateral frontal contusectomy followed by unilateral epidural hematoma (EDH) and contralateral contusion evacuation. There were four perioperative deaths (10.8%). At the end of one month all 29 cases were followed up and the majority were found in the good recovery group, followed equally in the other Glasgow outcome groups.9 SSBC is a safe, swift and cost effective technique in TBI with advantages of single anesthesia and surgical charges, postoperative care is the same for unilateral procedures, hospital stay is reduced, possible disastrous consequences of increase of opposite lesion avoided and is especially useful in developing countries where resources are limited.
Authors and Affiliations
Yam B Roka, MS, MCh
Keywords
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