Study Of The Effectiveness Of Decompressive Cranioectomy In Craniocerebral Trauma With Acute Subdural Hematoma

Objective: To investigate the surgical techniques and clinical outcome of decompressive craniectomy in the treatment of acute subdural hematoma.Methods: 35 cases with acute subdural hematoma of xiangya hospital who had received Standard large trauma craniotomy from November 2004 to December 2007 were analyzed retrospectively. All cases had certain traumatic history and were confirmed through CT. 24 cases underwent decompressive craniectomy, and in the other 11 cases, the cranial flap was restored after operation. All patients underwent postoperative CT.Results: In the decompressive craniectomy group, the outcome of patients was: 5 deaths, 9 were in vegetative state, 1 had severe disability, 4 had moderate disability and 5 had good recovery. In the restored cranial flap group, the outcome was: 1 death, 1 was in vegetative state, no cases had severe disability, 2 had moderate disability and 7 had good recovery.Conclusion: The simple, safe and effective standard large trauma craniotomy provide better operation mode for severe brain injury. While, this technique reduces fatality rate (20.8 %), it also results in a high physical disability rate and has got many postoperative complications. In few cases in this series, the effectiveness of the restored cranial flap group is superior to decompressive craniectomy group. This provides a clue for future treatment. But, the restored cranial flap technique should be carefully considered and candidates should be properly selected. If not, patients may have to undergo another decompressive craniectomy again.