To Research Severe Countrecoup Brain Injury Operation Method

Objective:to discuss the severe TBI operation strategy and method.Methods:43cases of severe TBI patients according to the first craniotomy treatment modalities are classified into three groups.26cases in group A first unilateral frontotemporal craniotomy hematoma removal+decompressive craniectomy,6cases in B group advance bilateral frontotemporal craniotomy hematoma removal+unilateral or bilateral decompressive craniectomy,11cases in C group to focus on parts of epidural hematoma; each group then instantly or later contralateral epidural hematoma operation. Comparison between the groups Glasgow postoperative score, contralateral hematoma thickness and degree of midline shift changes.Results:seventh days after operation, A, C group Glasgow coma score improved significantly compared with B group, the difference was statistically significant (P<0.05). Postoperative brain CT display, A, B hematoma thickness and degree of midline shift than in group C significantly (P<0.05), B group the biggest change.Conclusion:in severe craniocerebral injury patients after operation, two bleeding is very common, especially the primary injury site of epidural hematoma changes compared with contralateral subdural hematoma and cerebral contusion and laceration of brain tissue is more significant, the two compression is more important. For without herniation secondary or herniation in patients with early treatment, if the first obvious progression of epidural hematoma, may improve the prognosis.