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

Objective To explore emergency treatment strategies for the patients with brain hernia combined with hemorrhagic shock after severe traumatic brain injury and their effect on prognosis.Methods A retrospective analysis was made on 54 patients (study group) with brain hernia combined with hemorrhagic shock treated with selective treatment strategies from May 2006 to May 2009. Another 48 patients with the same injuries treated with no selective treatment strategies from April 2003 to April 2006 were used as control group. The mortality within one week and the GOS six months after injury were compared in two groups. Results There was no statistical difference in aspects of sex, age, injury mechanism, GCS and blood loss in both groups (P＞0.05). Thirteen patients died in the study group within the first week, with mortality rate of 24.1%. While 16 patients died in the control group at the first week, with mortality rate of 33.3% (P＜0.05). GOS half year after injury in the study group was better than that in the control group (P＜0.05).Conclusion Early selective treatment strategy based on degree of shock may obtain better outcome for patients with brain hernia combined with hemorrhagic shock after severe brain injury. Key words: Brain injuries;  Encephalocele;  Shock, hemorrhagic