Clinical application of large craniotomy decompression in treatment of severe craniocerebral injury combined with massive cerebral infarction

Objective To retrospectively review the efficacy of large craniotomy with subtemporal decompression in the treatment of severe craniocerebral injury combined with cerebral infarction.Methods Forty-eight patients suffering from severe craniocerebral injury combined with cerebral infarction were randomized into the treatment group (managed by large craniotomy decompression) and the control group (managed by clearance of hematoma by routine craniotomy ).A retrospective analysis was carried out to compare the cerebral infarction size between the two groups before operation and at day 1 and 1 week after operation and the outcomes of the two corresponding groups three months post-operatively.Results The infarction size of the treatment group was insignificant in comparison with that of the control group pre-operatively and at day 1 post-operatively,but was significantly smaller than that of the control group one week post-operatively (P ＜ 0.05 ).The mortality and moderate disability/good rate of the treatment and control groups presented significant differences three months post-operatively (21％,42％ vs 33％,25％ respectively,P ＜ 0.05 ).Conclusion Large craniotomy decompression is effective in treating severe craniocerebral injury combined with cerebral infarction and plays an important role in reducing disability and mortality. Key words: Decompression, surgical; Brain infarction; Craniocerebral trauma