Severe head injuries in three countries.

Jennett, Bryan; Teasdale, Graham M.; Galbraith, S; Pickard, John D.; Grant, Heath; Braakman, R.; Avezaat, C. J. J.; Maas, Andrew I. R.; Minderhoud, J.M.; Vecht, C J; Heiden, James S.; Small, Richard B.; Caton, William L.; Kurze, Theodore

doi:10.1136/jnnp.40.3.291

Cited by 477 publications

(157 citation statements)

References 16 publications

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“…Death rates were still as high as 50% [13][14][15] , but improvements in intensive care, such as artificial ventilation, were believed to be reducing early mortality. This change led on one hand to claims of 'miraculous' recoveries, but on the other hand raised concerns about increasing numbers of highly dependent survivors 16 .…”

Section: [H1] Background Of the Glasgow Outcome Scalementioning

confidence: 99%

“…Soon after its publication, the GOS was used in two ground-breaking prospective international multicentre studies of head injury 15 and nontraumatic coma 22 . In a 1978 article that identified head injury as a notable public health problem and emphasized the need for a greater understanding of outcome predictors, use of the GOS was recommended to neurosurgical centres worldwide to determine the effectiveness of neurosurgical interventions 23 .…”

Section: H2] Early Developmentmentioning

confidence: 99%

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The Glasgow Outcome Scale — 40 years of application and refinement

et al. 2016

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Section: [H1] Background Of the Glasgow Outcome Scalementioning

confidence: 99%

Section: H2] Early Developmentmentioning

confidence: 99%

The Glasgow Outcome Scale — 40 years of application and refinement

et al. 2016

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“…Other studies also found this item as predictive prognosis 3,4,11,14 . Jennett and Teasdale reported that GCS, in spite of being a good indicator of trauma severity, can show external influences such as alcoholic intoxication and hemodynamic instability 30 . They suggested that this rating be performed within six hours of trauma.…”

Section: Discussionmentioning

confidence: 99%

“…Prognostic factors -Age, anisocoria, polytrauma, tomographic findings and ICH have been reported as factors independent from prognosis 12,[25][26][27][28][29][30] . In this study none of these factors was statistically correlated to prognosis (p>0.05).…”

Section: Discussionmentioning

confidence: 99%

Decompressive craniotomy: prognostic factors and complications in 89 patients

Faleiro

Caetano

et al. 2008

Arq. Neuro-Psiquiatr.

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-Decompressive craniotomy (DC) is applied to treat post-traumatic intracranial hypertension (ICH).The purpose of this study is to identify prognostic factors and complications of unilateral DC. Eighty-nine patients submited to unilateral DC were retrospectively analyzed over a period of 30 months. Qui square independent test and Fisher test were used to identify prognostic factors. The majority of patients were male (87%). Traffic accidents had occurred in 47% of the cases. 64% of the patients had suffered severe head injury, while pupillary abnormalities were already present in 34%. Brain swelling plus acute subdural hematoma were the most common tomographic findings (64%). Complications occurred in 34.8% of the patients: subdural effusions in 10 (11.2%), hydrocephalus in 7 (7.9%) and infection in 14 (15.7%). The admittance Glasgow coma scale was a statistically significant predictor of outcome ( p=0.0309).KEY WORDS: head injury, intracranial hypertension, decompressive craniotomy. Craniotomia descompressiva: análise de fatores prognósticos e complicações em 89 pacientesResumo -A craniotomia descompressiva (CD) é técnica utilizada para tratamento da hipertensão intracraniana (HIC) pós-traumática. O objetivo do estudo foi determinar fatores prognósticos e complicações nos pacientes submetidos a esta técnica. Realizou-se estudo retrospectivo de 89 pacientes submetidos à CD unilateral para tratamento da HIC pós-traumática durante 30 meses. Utilizou-se testes do Qui-quadrado de independência e teste exato de Fisher para análise de fatores independentes de prognóstico. A maioria dos pacientes era do sexo masculino (87%). A causa mais comum foi o acidente de trânsito (47%). A maioria apresentava traumatismo cranioencefálico grave (64%), 34% já apresentavam anisocoria. O achado tomográfico mais comum foi a associação entre tumefação cerebral e hematoma subdural agudo (64%). Em 34,8% dos pacientes houve complicações inerentes à técnica: coleção subdural (11,2%), hidrocefalia (7,9%) e infecção (15,7%). A escala de coma de Glasgow à admissão correlacionou-se estatisticamente como fator prognóstico (p=0,0309). Decompressive craniotomy (DC) is a surgical method performed to immediately reduce intracranial pressure (ICP). It is usually indicated in cases of brain swelling (BS) and acute subdural hematoma (ASDH), or even for nontraumautic lesions in order to accommodate the swollen brain 1 . It consists of a unilateral craniotomy and dural augmentation. The bone can be temporarily stored in the abdominal subcutaneous tissue or can be disposed in case of a subsequent cranioplasty (with methylmethacrylate or titanium plate, among other materials). PALAVRAS-CHAVERecent studies have been evaluating DC efficacy when performed early in patients with severe traumatic brain injury (TBI) and with intracranial hypertension (ICH), yielding a superior result as compared to late performance or to specific clinical procedures (barbiturate coma and hypothermia) [2][3][4][5][6] . The purpose of this study was to evaluate prognostic...

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“…Early studies reported an association between clinical factors and an outcome in TBI patients 2,6,10,14,16,18) . These studies used early statistical methods and the independence model along with a large brain trauma database to identify combinations of acute clinical elements that are associated with patients' general outcomes 5,6,[8][9][10]21) .…”

Section: Introductionmentioning

confidence: 99%