Comparative Study Of Surgical Approach In The Bilateral Frontal Contusion

Objective:To investigate the development regularity of the bilateral frontal contusion (BFC) and the application of minimally invasive neurosurgery in it.The surgical methods of unilateral approach of cerebral falx incision was used to treat dissymmetric bilateral frontal contusion (DBFC). Summary unilateral craniotomy of falx incision(UCFI) operative time selection and indications.Methods:88patients with BFC admitted from September2010to September2013. Including58males and30females,the patients ranged in age from18to75years.50cases were due to traffic accidents,28cases were wounded in falls, and10cases were injured by crash from altitude. There were60cases caused by forces around the occiput and26cases caused by forces around the forehead.They were divided into two groups:a group of48cases of unilateral craniotomy;another group of40cases of bilateral craniotomy.They were no significant difference between two groups about the age,sex,GCS(Glasgow Coma Scale) and the time from injury to surgery(P>0.05).All patients had preoperative and postoperative CT to confirm intracranial changes. GOS(Glasgow Outcome Scale) in6month postinjury was observed.Incidence of mental disorders and language disorders was surveyed and analysed in6month postinjury. Two groups were compared operative time,length of stay in hospital.Results:GOS(Glasgow Outcome Scale) in6month postinjury was used to judge the prognosis,there was significant difference between two groups(P<0.05).38cases of good outcome,5cases of moderate disability,3cases of severe disability,1cases of vegetative status and1cases of dead in unilateral group.21cases of good outcome,9cases of moderate disability,5cases of severe disability,3cases of vegetative status and2cases of dead in bilateral group. Compared with the control group, incidence of mental disorders and language disorders were greatly reduced in the unilateral-operation group (P<0.05).There was significant difference between the two groups when comparing with operative time,length of stay in hospital (P<0.05).Conclusion:The use of unilateral approach of cerebral falx incision to remove bilateral frontal brain contusion and hematoma can significantly reduce the surgical trauma.The surgical method is the concrete application of Minimally Invasive Neurosurgery. Early surgery can reduce the occurrence of central cerebral hernia. The operative indication should be strictly grasped.