Abstract：Objective To investigate the risk factors of clinical deterioration and post-traumatic outcomes in patients with bilateral frontal contusion.Methods Retrospective analysis was performed of the clinical data about patients with bilateral frontal contusion treated between March 2011 and March 2013. Clinical factors for analysis included age, gender, mechanisms of injury, Glasgow coma scale (GCS) and imaging information. Statistical analysis was performed to find the predictors of clinical deterioration. These patients were followed up for 1 year after injury.Glasgow outcome scale (GOS) was used to evaluate the clinical outcome and to analyze the factors that affected the prognosis of the patients.Results 112 patients with bilateral frontal contusion were enrolled in this study and 17 of them suffered clinical deterioration. 95 patients achieved good outcomes (GOS,Ⅲ-Ⅴ) while 15 patients did not recover favorably. Gender(P=0.0039), GCS scores (P=0.0063), compression of basal cisterns(P=0.0426), hematoma volume (P<0.0001) were significantly correlated with clinical deterioration. Additionally, age (P=0.0004), GCS (P=0.0424), suprasellar cistern compression (P=0.0047), hematoma volume (P<0.0001), SAH(P=0.0145)and clinical deterioration (P<0.0001) were obviously correlated with post-traumatic outcomes.Conclusions Comprehensive evaluations of CGS and imaging performance are important for predicting clinical deterioration and post-traumatic prognosis.
Barthélemy E J, Melis M, Gordon E, et al. Decompressive craniectomy for severe traumatic brain injury: a systematic review[J]. World Neurosurg,2016,88:411-420.
[7]
Statham P F, Johnston R A. Delayed deterioration in patients with traumatic frontal contusions[J]. J Neurol Neurosurg Psychiatry,1989,52:351-354.
[8]
Eric C P, Randall M C. Talk and die revisited: bifrontal contusions and late deterioration[J]. J Trauma, 2011,71(6):1588-1592.
[9]
Andrews B T, Pitts L H. Functional recovery after traumatic transtentorial herniation[J]. Neurosurgery, 1992,30(3): 462.
[10]
Bullock M R, Chesnut R, Ghajar J, et al. Guidelines for the surgical management of traumatic brain injury[J]. Neurosurgery, 2006, 58 (3):2-62.
[11]
Liang G, Xuehai W, Jin H, et al. Intensive management and prognosis of 127 cases with traumatic bilateral frontal Contusions[J]. World Neurosurg ,2013,80(6):879-888.
[12]
Jirong D, Xuejian C A, Biao W, et al. Intracranial pressure monitoring for special patterns of frontal lobe contusions[J]. Chin J Traumatol, 2010,13(1):51-54.
[13]
Zhaofeng L, Bing L, Peng Q, et al. Surgical treatment of traumatic bifrontal contusions: when and how[J]. World Neurosurg, 2016,93(3):261-269.
2017, Vol. 28 
