Management of Severe Traumatic Brain Injury by Decompressive Craniectomy

Objective To assess the beneficial effect of decompressive craniectomy in the treatment of severe traumatic brain injury patients.Methods investigated 52 patients who underwent decompressive craniectomy.Intracranial pressure,cranial computed tomographic scan features(midline shift,visibility of ventricles,and basal cisterns) and outcome were evaluated before and after craniectomy.Results 38 patients(73.1%) underwent rapid surgical decompression within 5.1±3.2 hours after trauma;in 14 patients(26.9%),delayed surgical decompression was performed 49.2±50.1 hours after injury.Decompressive craniectomy significantly decreased intracranial pressure,decreased midline shift,and improved visibility of the basal cisterns.Patients who underwent rapid surgical decompression had a significantly better outcome than patients who underwent delayed surgical decompression.Conclusions Decompressive craniectomy should have a beneficial effect on severe traumatic brain injury patients outcome.