Evaluation of prognostic factors of decompressive craniectomy in the treatment of severe traumatic brain injury

Saade, Nelson; Veiga, José Carlos Esteves; Cannoni, Luiz Fernando; Haddad, Luciano; Araújo, João Luiz Vitorino

doi:10.1590/0100-69912014004006

Cited by 14 publications

(17 citation statements)

References 27 publications

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“…The analysis of Glasgow Coma Scale in relation to the clinical progression was also performed and is encouraged in the clinical practice for optimal evaluation of patients with CET. Confirming the literature, the present study observed that the more severe the CET the higher the probability of progressing to death (Saade et al, 2014).…”

Section: Discussionsupporting

confidence: 91%

Epidemiological Aspects of Cranioencephalic Trauma at Cuiabá Municipal Hospital, Brazil

Vasconcelos

Dias

Wippel

et al. 2018

Int. J. Odontostomat.

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Cranioencephalic trauma (CET) is defined is the combination of neural and vascular injuries and their inflammatory effects in the brain, skull and scalp. This modality of trauma may lead to motor, psychological and cognitive sequels or even death. The present study aimed to assess the main epidemiological aspects in victims of CET treated at Cuiabá Municipal Hospital (CMH), Brazil. An observational and analytical study was performed in the medical records of patients diagnosed with CET treated at CMH between July and December of 2000, 2006 and 2011. The information retrieved from the patients consisted of age, sex, place of residence, cause of trauma, association with other trauma, outcomes (death or discharge) and the severity of neurological effect (Glasgow Coma Scale). The data obtained was analyzed descriptively with absolute (n) and relative (%) quantification. Medical records of 669 victims were analyzed, out of which 567 were males (84.7 %). Male patients were aged between 20 and 39 years old (mean age: 32.8 years). The most prevalent cause of trauma was the motorcycle accident (26.6 %). The neurological severity of the CET was mild in most of the cases (32.5 %). Considering the place of residence, most of the patients (n=331; 49.5 %) were from the capital city of Mato Grosso State (Cuiabá, Brazil). Four-hundred seventy-nine (71.6 %) patients progressed without death. A high prevalence rate of CET was observed at CMH. Major attention must be given to young adult victims of motorcycle accidents.

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Section: Discussionsupporting

confidence: 91%

Epidemiological Aspects of Cranioencephalic Trauma at Cuiabá Municipal Hospital, Brazil

Vasconcelos

Dias

Wippel

et al. 2018

Int. J. Odontostomat.

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“…In our report alcohol did not influence the outcome of our patients but we did not consider its blood level. Absence of pupillary reflex has been repeatedly reported as a negative prognostic factor (9,19). Possibly because of a limi ted number of patients with non-reactive pupils and the fact that uni-or bilaterality of this was not taken into account we did not observed similar result in our group of patients.…”

Section: Discussioncontrasting

confidence: 44%

Efficiency and Limitations of Decompressive Craniectomy in Patients after Traumatic Brain Injury – Preliminary Results

Hanko

Richterová

Kolarovszki

2017

Acta Medica Martiniana

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Introduction: Decompressive craniectomy (DC) has been recently proven effective tier II therapeutic procedure in the treatment of refractory posttraumatic intracranial hypertension. However, its full potential and effectivity is yet to be described and this surgery remains controversial. The goals of our study include analysis of efficiency of DC and description of risk factors associated with unfavourable outcome. Methods: 24 patients who underwent DC at the Clinic of Neurosurgery, JFM CU in Martin, during years 2015–2016 were prospectively observed. Selected demographic, clinical, and radiographic factors were analysed and compared with patient’s GOS (Glasgow Outcome Scale) at the time of their first ambulatory control (after 3.5 months in average). Results: We observed mortality of 29.17 %. Good outcome (GOS 4–5) was achieved by 29.17 % of the patients as well. Preoperative GCS ≤ 5 (p = 0.049), intraventricular bleeding (p = 0.0268), midline shift ≥ 15 mm (p = 0.0067), and the volume of intracranial lesion (R = −0.41, p = 0.046), especially its extracerebral component (R = −0.46, p = 0.02), were identified as statistically significant negative prognostic factors. Conclusion: DC is effective in the management of patients with traumatic brain injury. Good outcome is achieved by 29.17 % of the patients. Described negative prognostic factors (preoperative GCS ≤ 5, intraventricular bleeding, midline shift ≥ 15 mm, and increasing the volume of traumatic mass lesion) could help in targeting this surgery only to patients who are expected to benefit from it.

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“…Их изложение целесообразно начать с наи-более тревожных механизмов развития мидри-аза -парасимпатических стволовых рас-стройств с поражением ядерного комплекса и/или внутримозговой части глазодвигатель-ного нерва, обусловленных локальными нару-шениями гемодинамики в верхнемедиальных отделах ствола [13,17] или (что встречается го-раздо чаще) его диффузной ишемией, метаболи-ческой энцефалопатией, черепно-мозговой трав-мой, аневризмой церебральных сосудов, остро возникшим масс-эффектом (кровоизлиянием), опухолью, височно-тенториальным вклинением [22,34,38,40,48,62,79]. В таких ситуациях мидриаз указывает на сторону поражения, сви-детельствует об ургентности ситуации и всегда сочетается с другой неврологической сим-птоматикой!…”

Section: Discussionunclassified

Unilateral mydriasis after video-assisted thoracic thymectomy: case report and review of literature

Panova

Юрьевна²,

Nikolaenko

et al. 2018

Ophthalmology Reports

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Evaluation of prognostic factors of decompressive craniectomy in the treatment of severe traumatic brain injury

Abstract: among the factors studied, only the presence of mydriasis with absence of pupillary reflex, scoring 4 and 5 in the Glasgow Coma Scale, association of intracranial lesions and diversion of midline structures (DML) exceeding 15 mm correlated statistically as predictors of poor prognosis.

Cited by 14 publications

References 27 publications

Epidemiological Aspects of Cranioencephalic Trauma at Cuiabá Municipal Hospital, Brazil

Epidemiological Aspects of Cranioencephalic Trauma at Cuiabá Municipal Hospital, Brazil

Efficiency and Limitations of Decompressive Craniectomy in Patients after Traumatic Brain Injury – Preliminary Results

Unilateral mydriasis after video-assisted thoracic thymectomy: case report and review of literature

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