Clinical Analysis Of The External Cerebral Herniation After Decompressive Craniectomy In Traumatic Brain Injury

Objective:Investigate severe traumatic brain injury patients who after hemicraniectomy patients, Contents of The External Cerebral Herniation After Decompressive Craniectomy in Traumatic Brain Injury And Early Cranioplasty SurgeryMethod:30cases of severe traumatic brain injury who undergo hemicraniectomy after traumatic brain injury were retrospectively studied by analyzing the changes of the contents of the different time periods of postoperative encephalocele, and preoperative GCS, GOS score six months after operation, using statistical software to analyzeResult:(1) In30cases of hemicraniectomy patients after severe traumatic brain injury. The contents of the external cerebral hernia-tion,,the incidence of hematoma-edema lesions is40%, the occur-rence time of it is1.17days; the incidence of edema-hematoma leisions is56%.The occurrence time of it is3.73days; the incidence of encephalomalacia is13.3%, the emergence time of it is30.5days. The incidence of ventricular dilatation is63%, the beginning of ventricular dilatation is14.06days, the obvious of the ventricular dilatation is37.7days. PHI (progress bleeding in brain trauma) after hemicraniectomy in severe traumatic brain injury patients is also a complication in higher incidence, its occurrence will greatly affect the prognosis of patients;(2) Of30cases of severe cranial traumatic brain injury who undergo the hemicraniectomy, the occurrence rate of the external cerebral herniation is100%. Which one person died (mortality3.3%); long-term coma of12persons (40%); severe disability in6persons (20%); mild disability in9persons (30%);2persons restore well (6.7%).Conclusion:The occurrence rate of the external cerebral herniation who have brain injury undergo the craniectomy is100%。According to the encephalocele contents of encephalocele, hematoma-edema lesions appear earliest, the next one is edema-hematoma leisions, then to the encephalomalacia.When the brain tissue transfer into the encephalo-malacia, which will greatly affect the normal function of the brain tissue.The time of ventricular dilatation first appeared immediately following the appears of encephalomalacia, and becoming most obvious around30days after operation which will reduce the function of brain tissue further. Therefore, according the conventional methods, hemic-raniectomy cranioplasty undergo after3months after operation. So,we suggest the time of hemicraniectomy cranioplasty and Ventriculo-peritoneal shunt in advance to3months ago, in a bid to minimize the brain tissue becoming malacia and loss of brain function caused by ventricular dilatation. PHI is also a important complication after craniectomy which will greatly have impact on the prognosis of patients, in such circumstance,contusion of brain tissue during the were surgical operation, should try to clean and to stop the bleeding.