Treatment strategies for brain hernia combined with hemorrhagic shock following severe traumatic brain injury

Objective:To explore emergency treatment strategies for patients with brain hernia combined with hemorrhagic shock after severe traumatic brain injury and to discuss their effects on prognosis.Methods:A retrospective analysis was made on 32 patients(observation group)with brain hernia combined with hemorrhagic shock treated by selective strategies on the basis of integrative strategies from September 2009 to April 2011;another 22 patients(control group)with the same injuries were treated by routine strategies. Mortality within one week and glasgow outcome score(GOS)at six months after injury were compared between two groups.Results: Mortality rate was 34.4%(11/32)in observation group and 45.5%(10/22)in control group two weeks later(P 0.05).GOS disability rating(Ⅰ,Ⅱ level)were higher in observation group than in control group at six months after injury;GOS disability rating(Ⅲ,Ⅴ level)were lower in observation group than in control group at six months after injury(χ 2 =4.909,P=0.027).Conclusions:Early selective strategies based on degree of shock combined with integrative strategies may obtain better outcome for patients with brain hernia combined with hemorrhagic shock after severe brain injury.