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Prevention of acute encephalorele in large bone flap craniotomy decompresion for contrecoup subdural hematoma |
PENG Jun,YANG Bailin,YU Chao,WANG Huan,and XU QiMing |
Department of Neurosurgery, Jiangxi Provincial Corps Hospital,Chinese People’s Armed Police Force,Nanchang 330001,China |
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Abstract Objective To investigate the effect of prevention and treatment of acute encephalocele in patients with contreconp subdural hematomas undergoing standard big bone flap craniotomy decompression.Methods 86 patients with traumatic brain injury undergoing neurosurgery from May 2010 to May 2015 were analyzed retrospectively and randomly divided into study group and conventional group,43 each.The conventional group were treated with conventional bone flap craniotomy, and the study group was treated with standard large bone flap craniotomy, and the effects of the two groups were compared.Results In the study group,intraoperative encephalocele rate was 39.53%, the incidence of postoperative incisional hernia (11.63%) was significantly lower than in the conventional group (67.44%), (34.88%) (P<0.05). In the study group, midline postoperative recovery rate was 72.09%,significantly higher than in the conventional group (46.51%,P<0.05).In the two groups,delayed hematoma incidence and mortality were not significantly different. GCS score was significantly higher than the value in the postoperative 1,3,7 d conventional group patients (P<0.05). According to GOS evaluation criteria, prognosis in the study group after six months was better than that in conventional group (P<0.05).Conclusions Standard largebone flap craniotomy decompression in contrecoup subdural hematoma is markedly effective for prevention and treatment of intraoperative acute encephalocele, and favonrable to improving the patient short term prognosis.
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Received: 08 January 2016
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