According to which factors in severe traumatic brain injury craniectomy could be beneficial
Identifieur interne : 000069 ( Main/Exploration ); précédent : 000068; suivant : 000070According to which factors in severe traumatic brain injury craniectomy could be beneficial
Auteurs : George Fotakopoulos [Grèce] ; Eleni Tsianaka [Grèce] ; Konstantinos Vagkopoulos [Grèce] ; Kostas N. Fountas [Grèce]Source :
- Surgical Neurology International [ 2229-5097 ] ; 2016.
Abstract
To investigate the clinical outcome at 101 patients undergoing decompressive craniectomy (DC) after severe traumatic brain injury (TBI).
Age, Glasgow Coma Scale (GCS) at the time of intubation, and the intraoperative intracranial pressure (ICP) were recorded. Formal DC was performed in all cases and the square surface of bone flap was calculated in cm2 based on the length and the width from computed tomography scan.
The difference of good neurological recovery (Glasgow outcome score 4–5), between patients with ICP ≤20 mmHg, GCS ≥5, age ≤60 years, and bone flap ≥130 cm2 and those with ICP >20 mmHg, GCS <5, age >60 years, and bone flap <130 cm2, was statistically significant.
Although the application of DC in severe TBI is controversial and the population in this study is small, our study demonstrates the threshold of the specific factors (patient age, ICP and GCS on the day of the surgery and the size of the bone flap) which may help in the decision of performing DC. Furthermore, this study proves that the different combinations and mainly at the same time involvement of all prognostic parameters (age <60, GCS <5, bone flap ≥130 cm2, and ICP ≤20 at time of DC surgery) allow a better outcome.
Url:
DOI: 10.4103/2152-7806.176671
PubMed: 26981320
PubMed Central: 4774169
Affiliations:
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<record><TEI><teiHeader><fileDesc><titleStmt><title xml:lang="en">According to which factors in severe traumatic brain injury craniectomy could be beneficial</title><author><name sortKey="Fotakopoulos, George" sort="Fotakopoulos, George" uniqKey="Fotakopoulos G" first="George" last="Fotakopoulos">George Fotakopoulos</name><affiliation wicri:level="1"><nlm:aff id="aff1">Department of Neurosurgery, University Hospital of Thessaly, University Hospital of Larissa, Biopolis, 41110 Larissa, Thessaly, Greece</nlm:aff><country xml:lang="fr">Grèce</country><wicri:regionArea>Department of Neurosurgery, University Hospital of Thessaly, University Hospital of Larissa, Biopolis, 41110 Larissa, Thessaly</wicri:regionArea><wicri:noRegion>Thessaly</wicri:noRegion></affiliation></author><author><name sortKey="Tsianaka, Eleni" sort="Tsianaka, Eleni" uniqKey="Tsianaka E" first="Eleni" last="Tsianaka">Eleni Tsianaka</name><affiliation wicri:level="1"><nlm:aff id="aff1">Department of Neurosurgery, University Hospital of Thessaly, University Hospital of Larissa, Biopolis, 41110 Larissa, Thessaly, Greece</nlm:aff><country xml:lang="fr">Grèce</country><wicri:regionArea>Department of Neurosurgery, University Hospital of Thessaly, University Hospital of Larissa, Biopolis, 41110 Larissa, Thessaly</wicri:regionArea><wicri:noRegion>Thessaly</wicri:noRegion></affiliation></author><author><name sortKey="Vagkopoulos, Konstantinos" sort="Vagkopoulos, Konstantinos" uniqKey="Vagkopoulos K" first="Konstantinos" last="Vagkopoulos">Konstantinos Vagkopoulos</name><affiliation wicri:level="1"><nlm:aff id="aff1">Department of Neurosurgery, University Hospital of Thessaly, University Hospital of Larissa, Biopolis, 41110 Larissa, Thessaly, Greece</nlm:aff><country xml:lang="fr">Grèce</country><wicri:regionArea>Department of Neurosurgery, University Hospital of Thessaly, University Hospital of Larissa, Biopolis, 41110 Larissa, Thessaly</wicri:regionArea><wicri:noRegion>Thessaly</wicri:noRegion></affiliation></author><author><name sortKey="Fountas, Kostas N" sort="Fountas, Kostas N" uniqKey="Fountas K" first="Kostas N." last="Fountas">Kostas N. Fountas</name><affiliation wicri:level="1"><nlm:aff id="aff1">Department of Neurosurgery, University Hospital of Thessaly, University Hospital of Larissa, Biopolis, 41110 Larissa, Thessaly, Greece</nlm:aff><country xml:lang="fr">Grèce</country><wicri:regionArea>Department of Neurosurgery, University Hospital of Thessaly, University Hospital of Larissa, Biopolis, 41110 Larissa, Thessaly</wicri:regionArea><wicri:noRegion>Thessaly</wicri:noRegion></affiliation><affiliation wicri:level="1"><nlm:aff id="aff2">Center for Research and Technology of Thessaly, 38500 Larissa, Greece</nlm:aff><country xml:lang="fr">Grèce</country><wicri:regionArea>Center for Research and Technology of Thessaly, 38500 Larissa</wicri:regionArea><wicri:noRegion>38500 Larissa</wicri:noRegion></affiliation></author></titleStmt><publicationStmt><idno type="wicri:source">PMC</idno><idno type="pmid">26981320</idno><idno type="pmc">4774169</idno><idno type="url">http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4774169</idno><idno type="RBID">PMC:4774169</idno><idno type="doi">10.4103/2152-7806.176671</idno><date when="2016">2016</date><idno type="wicri:Area/Pmc/Corpus">000051</idno><idno type="wicri:explorRef" wicri:stream="Pmc" wicri:step="Corpus" wicri:corpus="PMC">000051</idno><idno type="wicri:Area/Pmc/Curation">000051</idno><idno type="wicri:explorRef" wicri:stream="Pmc" wicri:step="Curation">000051</idno><idno type="wicri:Area/Pmc/Checkpoint">000025</idno><idno type="wicri:explorRef" wicri:stream="Pmc" wicri:step="Checkpoint">000025</idno><idno type="wicri:Area/Ncbi/Merge">000F68</idno><idno type="wicri:Area/Ncbi/Curation">000F68</idno><idno type="wicri:Area/Ncbi/Checkpoint">000F68</idno><idno type="wicri:doubleKey">2229-5097:2016:Fotakopoulos G:according:to:which</idno><idno type="wicri:Area/Main/Merge">000070</idno><idno type="wicri:Area/Main/Curation">000069</idno><idno type="wicri:Area/Main/Exploration">000069</idno></publicationStmt><sourceDesc><biblStruct><analytic><title xml:lang="en" level="a" type="main">According to which factors in severe traumatic brain injury craniectomy could be beneficial</title><author><name sortKey="Fotakopoulos, George" sort="Fotakopoulos, George" uniqKey="Fotakopoulos G" first="George" last="Fotakopoulos">George Fotakopoulos</name><affiliation wicri:level="1"><nlm:aff id="aff1">Department of Neurosurgery, University Hospital of Thessaly, University Hospital of Larissa, Biopolis, 41110 Larissa, Thessaly, Greece</nlm:aff><country xml:lang="fr">Grèce</country><wicri:regionArea>Department of Neurosurgery, University Hospital of Thessaly, University Hospital of Larissa, Biopolis, 41110 Larissa, Thessaly</wicri:regionArea><wicri:noRegion>Thessaly</wicri:noRegion></affiliation></author><author><name sortKey="Tsianaka, Eleni" sort="Tsianaka, Eleni" uniqKey="Tsianaka E" first="Eleni" last="Tsianaka">Eleni Tsianaka</name><affiliation wicri:level="1"><nlm:aff id="aff1">Department of Neurosurgery, University Hospital of Thessaly, University Hospital of Larissa, Biopolis, 41110 Larissa, Thessaly, Greece</nlm:aff><country xml:lang="fr">Grèce</country><wicri:regionArea>Department of Neurosurgery, University Hospital of Thessaly, University Hospital of Larissa, Biopolis, 41110 Larissa, Thessaly</wicri:regionArea><wicri:noRegion>Thessaly</wicri:noRegion></affiliation></author><author><name sortKey="Vagkopoulos, Konstantinos" sort="Vagkopoulos, Konstantinos" uniqKey="Vagkopoulos K" first="Konstantinos" last="Vagkopoulos">Konstantinos Vagkopoulos</name><affiliation wicri:level="1"><nlm:aff id="aff1">Department of Neurosurgery, University Hospital of Thessaly, University Hospital of Larissa, Biopolis, 41110 Larissa, Thessaly, Greece</nlm:aff><country xml:lang="fr">Grèce</country><wicri:regionArea>Department of Neurosurgery, University Hospital of Thessaly, University Hospital of Larissa, Biopolis, 41110 Larissa, Thessaly</wicri:regionArea><wicri:noRegion>Thessaly</wicri:noRegion></affiliation></author><author><name sortKey="Fountas, Kostas N" sort="Fountas, Kostas N" uniqKey="Fountas K" first="Kostas N." last="Fountas">Kostas N. Fountas</name><affiliation wicri:level="1"><nlm:aff id="aff1">Department of Neurosurgery, University Hospital of Thessaly, University Hospital of Larissa, Biopolis, 41110 Larissa, Thessaly, Greece</nlm:aff><country xml:lang="fr">Grèce</country><wicri:regionArea>Department of Neurosurgery, University Hospital of Thessaly, University Hospital of Larissa, Biopolis, 41110 Larissa, Thessaly</wicri:regionArea><wicri:noRegion>Thessaly</wicri:noRegion></affiliation><affiliation wicri:level="1"><nlm:aff id="aff2">Center for Research and Technology of Thessaly, 38500 Larissa, Greece</nlm:aff><country xml:lang="fr">Grèce</country><wicri:regionArea>Center for Research and Technology of Thessaly, 38500 Larissa</wicri:regionArea><wicri:noRegion>38500 Larissa</wicri:noRegion></affiliation></author></analytic><series><title level="j">Surgical Neurology International</title><idno type="ISSN">2229-5097</idno><idno type="eISSN">2152-7806</idno><imprint><date when="2016">2016</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en"><sec id="st1"><title>Background:</title><p>To investigate the clinical outcome at 101 patients undergoing decompressive craniectomy (DC) after severe traumatic brain injury (TBI).</p></sec><sec id="st2"><title>Methods:</title><p>Age, Glasgow Coma Scale (GCS) at the time of intubation, and the intraoperative intracranial pressure (ICP) were recorded. Formal DC was performed in all cases and the square surface of bone flap was calculated in cm<sup>2</sup> based on the length and the width from computed tomography scan.</p></sec><sec id="st3"><title>Results:</title><p>The difference of good neurological recovery (Glasgow outcome score 4–5), between patients with ICP ≤20 mmHg, GCS ≥5, age ≤60 years, and bone flap ≥130 cm<sup>2</sup> and those with ICP >20 mmHg, GCS <5, age >60 years, and bone flap <130 cm<sup>2</sup>, was statistically significant.</p></sec><sec id="st4"><title>Conclusion:</title><p>Although the application of DC in severe TBI is controversial and the population in this study is small, our study demonstrates the threshold of the specific factors (patient age, ICP and GCS on the day of the surgery and the size of the bone flap) which may help in the decision of performing DC. Furthermore, this study proves that the different combinations and mainly at the same time involvement of all prognostic parameters (age <60, GCS <5, bone flap ≥130 cm<sup>2</sup>, and ICP ≤20 at time of DC surgery) allow a better outcome.</p></sec></div></front><back><div1 type="bibliography"><listBibl><biblStruct><analytic><author><name sortKey="Aarabi, B" uniqKey="Aarabi B">B Aarabi</name></author><author><name sortKey="Hesdorffer, Dc" uniqKey="Hesdorffer D">DC Hesdorffer</name></author><author><name sortKey="Ahn, Es" uniqKey="Ahn E">ES Ahn</name></author><author><name sortKey="Aresco, C" uniqKey="Aresco C">C Aresco</name></author><author><name sortKey="Scalea, Tm" uniqKey="Scalea T">TM Scalea</name></author><author><name sortKey="Eisenberg, Hm" uniqKey="Eisenberg H">HM Eisenberg</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Albanese, J" uniqKey="Albanese J">J Albanèse</name></author><author><name sortKey="Leone, M" uniqKey="Leone M">M 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Williams</name></author><author><name sortKey="Magnotti, Lj" uniqKey="Magnotti L">LJ Magnotti</name></author><author><name sortKey="Croce, Ma" uniqKey="Croce M">MA Croce</name></author><author><name sortKey="Hargraves, Bb" uniqKey="Hargraves B">BB Hargraves</name></author><author><name sortKey="Fischer, Pe" uniqKey="Fischer P">PE Fischer</name></author><author><name sortKey="Schroeppel, Tj" uniqKey="Schroeppel T">TJ Schroeppel</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Ziai, Wc" uniqKey="Ziai W">WC Ziai</name></author><author><name sortKey="Port, Jd" uniqKey="Port J">JD Port</name></author><author><name sortKey="Cowan, Ja" uniqKey="Cowan J">JA Cowan</name></author><author><name sortKey="Garonzik, Im" uniqKey="Garonzik I">IM Garonzik</name></author><author><name sortKey="Bhardwaj, A" uniqKey="Bhardwaj A">A Bhardwaj</name></author><author><name sortKey="Rigamonti, D" uniqKey="Rigamonti D">D Rigamonti</name></author></analytic></biblStruct></listBibl></div1></back></TEI><affiliations><list><country><li>Grèce</li></country></list><tree><country name="Grèce"><noRegion><name sortKey="Fotakopoulos, George" sort="Fotakopoulos, George" uniqKey="Fotakopoulos G" first="George" last="Fotakopoulos">George Fotakopoulos</name></noRegion><name sortKey="Fountas, Kostas N" sort="Fountas, Kostas N" uniqKey="Fountas K" first="Kostas N." last="Fountas">Kostas N. Fountas</name><name sortKey="Fountas, Kostas N" sort="Fountas, Kostas N" uniqKey="Fountas K" first="Kostas N." last="Fountas">Kostas N. Fountas</name><name sortKey="Tsianaka, Eleni" sort="Tsianaka, Eleni" uniqKey="Tsianaka E" first="Eleni" last="Tsianaka">Eleni Tsianaka</name><name sortKey="Vagkopoulos, Konstantinos" sort="Vagkopoulos, Konstantinos" uniqKey="Vagkopoulos K" first="Konstantinos" last="Vagkopoulos">Konstantinos Vagkopoulos</name></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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