Application Of Surgical Decompression With Standard Large Craniotomy On The Patients With Severe Traumatic Brain Injury

Objective To study the application of decompression with standard large craniotomy on the patients with severe traumatic brain injury.Method January2006to March2011,106cases of traumatic brain injury patients in our hospital neurosurgery department, meet the diagnostic criteria of severe traumatic brain injury, There were67males and39females; ages8to71years old, on average (31.3±1.7) years old, Traffic accident in73cases, combat injuries in20cases,13cases of fall injury, closed head injury;0.5-3h after injury to the hospital an average of (1.1±0.6) h, all cases were supratentorial intracerebral hematoma, there is widespread cerebral contusion, cerebral edema, midline shift more than10mm; unilateral mydriasis78casesbilateral mydriasis28cases; GCS score of6to8points in79cases to the hospital;3to5points in27cases. Using standard large trauma decompression treatment, patients were followed up for6to24months, to assess the clinical reference the GOS prognostic score.0.5-3h after injury to the hospital an average of (1.1±0.6) h, all cases were supratentorial intracerebral hematoma, there is widespread cerebral contusion, cerebral edema, midline shift more than10mm; unilateral mydriasis78casesbilateral mydriasis28cases; GCS score of6to8points79cases to the hospital;3to5points in27cases. Using American standard large trauma decompression treatment, patients were followed up for6to24months, to assess the clinical reference the GOS prognostic score.Result Good25cases (23.58%), moderate disability in23cases (21.69%), severe disability in21(19.81%), plant survival in13cases (12.26%), and24cases (22.64%) died.Conclussion An obvious decrease in the mortality and improvement in the prognosis can be gained by surgical decompression with standard large craniotomy on the patients with severe traumatic brain injury, the treatment of severe traumatic brain injury got good results, is worth promoting. The procedure does not resolve the brain tissue of patients with primary irreversible damage, such patients mortality and morbidity remains high, how to further reduce the mortality and morbidity of the existing infrastructure, will be the next nervesurgical research is another important issue.