Clinical Study Of Bilaterall Decompressive Craniotomy To Treat Double Anisomerous Severe Countercoup Brain Injury

Objective: To investigate the efficacy of bilateral decompressive craniotomy to treat double anisomerous severe countercoup brain injury.Methods: 52 inpatients with severe countercoup brain injury were enrolled from department of neurosurgeryin the 9th affiliated hospital of Guangxi Medical University during February 2005 to December 2008 .The total of 24 cases patients with double anisomerous severe countercoup brain injury in treatment group were treated by bilateral decompressive craniotomy and 28 cases patients in control group underwent traditional unilateral craniotomy , the two groups were compared prospectively and analyzed statistically to assess the curative effect.Results: In treatment group, 20 cases survived, amongwhich 9 cases with good recovery, 5 cases of moderately disabled, 3 cases of severely disabled, 3 cases of vegetative survival, and 4 death cases. There were 28 cases in control group, amongwhich 4 cases got good recovery, 3 cases moderately disabled ,5cases of severely disabled, 4 cases vegetative survival, and 12 death cases. We can see the frequency of encephalocele,incisional hernia and mortality in treatment group was significantly lower than that in control group,but the frequency of good recovery has a reverse result.Conclusion: bilateral decompressive craniotomy can prevent and treat acute encephalocele and incisional hernia in double anisomerous severe traumatic brain injury successfully and improve the prognosis and reduce the mortality.