The outcome from severe head injury with early diagnosis and intensive management

Becker, Donald P.; Miller, J. D.; Ward, John D.; Greenberg, Richard P.; Young, Harold F.; Sakalas, Romas

doi:10.3171/jns.1977.47.4.0491

Cited by 825 publications

(224 citation statements)

References 22 publications

Supporting

Mentioning

196

Contrasting

Unclassified

Order By: Relevance

“…The factor of greatest influence on outcome is the time from injury to surgery. Patients that undergo DC within the first 4 hours following trauma have better outcomes compared to those who undergo DC after 4 hours (2,13,25,26,30). Münch et al reported a mortality rate of 30% for patients that underwent DC within 4 hours, compared to 90% for those after 4 hours (25).…”

Section: Discussionmentioning

confidence: 99%

Effect of early bilateral decompressive craniectomy on outcome for severe traumatic brain injury

Akyuz

Uçar²,

Açikbas³

et al. 2009

Turkish Neurosurgery

View full text Add to dashboard Cite

AIM:Debate continues as to whether decompressive craniectomy (DC) is an effective treatment for severe traumatic brain injury (STBI). DC is mostly used as a second tier treatment option. The aim of this study was determined whether early bilateral DC is effective as a first tier treatment option in patients with STBI. MATERIAL and METHODS:The study compared two groups. Group 1 comprised 36 STBI patients for whom control of intracranial pressure (ICP) was not achieved with conservative treatment methods according to radiological and neurological findings. These patients underwent bilateral or unilateral DC as a second tier treatment. Group 2 comprised 40 STBI patients who underwent early bilateral DC as a first tier treatment. RESULTS: Group 2 patients had a mean better outcome than Group 1patients, especially for patients with a GCS 6-8. Postoperative ICP was lower in Group 2 patients than Group 1 patients. CONCLUSION: This study indicates that early bilateral DC can be effective for controlling ICP in STBI patients. It is likely the favorable outcome results for Group 2 patients reflects the relatively short time between trauma and surgery. Therefore, these data indicate early bilateral DC can be considered as a first tier treatment in STBI patients.

show abstract

Section: Discussionmentioning

confidence: 99%

Effect of early bilateral decompressive craniectomy on outcome for severe traumatic brain injury

Akyuz

Uçar²,

Açikbas³

et al. 2009

Turkish Neurosurgery

View full text Add to dashboard Cite

show abstract

“…4,35 This expansion began with Lawrence Marshall's 2-part paper, with Part 1 focusing on the significance of ICP monitoring via a ventricular catheter. 32 Thomas Saul and Thomas Ducker followed in 1982 with an analysis of mortality rate stratified by ICP.…”

Section: Traumatic Brain Injurymentioning

confidence: 99%

The history of external ventricular drainage

Srinivasan

O’Neill

Jho

et al. 2014

JNS

100

View full text Add to dashboard Cite

External ventricular drainage (EVD) is one of the most commonly performed neurosurgical procedures. It was first performed as early as 1744 by Claude-Nicholas Le Cat. Since then, there have been numerous changes in technique, materials used, indications for the procedure, and safety. The history of EVD is best appreciated in 4 eras of progress: development of the technique (1850-1908), technological advancements (1927-1950), expansion of indications , and accuracy, training, and infection control (1995-present). While EVD was first attempted in the 18th century, it was not until 1890 that the first thorough report of EVD technique and outcomes was published by William Williams Keen. He was followed by H. Tillmanns, who described the technique that would be used for many years. Following this, many improvements were made to the EVD apparatus itself, including the addition of manometry by Adson and Lillie in 1927, and continued experimentation in cannulation/drainage materials. Technological advancements allowed a great expansion of indications for EVD, sparked by Nils Lundberg, who published a thorough analysis of the use of intracranial pressure (ICP) monitoring in patients with brain tumors in 1960. This led to the application of EVD and ICP monitoring in subarachnoid hemorrhage, Reye syndrome, and traumatic brain injury. Recent research in EVD has focused on improving the overall safety of the procedure, which has included the development of guidance-based systems, virtual reality simulators for trainees, and antibiotic-impregnated catheters.

show abstract

“…Recent evidence suggests that mortality can be reduced without significantly increasing the number of people surviving in a vegetative or severely disabled stale. 1 In a review of avoidable factors in the deaths of head-injured patients who talked after the injury, 26 per cent had an airway obstruction, 22 per cent had hypotension (primarily intraoperative), and 17 per cent had poorly controlled seizures. 2 The anaesthetist has the technical skills and the knowledge of physiology and pharmacology to make a major ctmtribution to the well being of these patients.…”

mentioning

confidence: 99%