Clinical effect of early decompressive craniectomy on severe traumatic brain injury

Objective To evaluate the clinical effect of early decompressive craniectomy on severe traumat-ic brain injury.Methods The clinical and neuroimaging records of early decompressive craniectomy in 29 patients with severe traumatic brain injury were collected.And the following information was analyzed retrospectively for each patient:GCS score on admission,pre-and postoperative midline shift,the state of the lateral ventricles and central pond,area of the craniectomy,and early and late neurological outcome.Results The average time to surgery af-ter trauma was 4.04 hours,which was related to clinical outcome(r=0.1507;P=0.0401).The average of the midline shifts decreased after decompression(P=0.0001).And the visibility of the central pond improved significantly after craniectomy(P=0.0002).Decreases in the midline shifts correlated significantly with an improvement in the visibility of the central pond(r=0.4209;P=0.0230).There was also a significant correlation between clinical status on admission and clinical outcome(P0.0001).Conclusion Early decompressive craniectomy can improve the clinical outcome of the patients with severe traumatic brain injury,which was related with the severity of the underlying injuries.