Advanced search
Publication Cover
Therapeutics and Clinical Risk Management Volume 11, 2015 - Issue
Submit an article Journal homepage
61
Views
14
CrossRef citations to date
0
Altmetric
Original Research

Decompressive craniectomy for severe traumatic brain injury patients with fixed dilated pupils

Xiang Mao1 Department of Neurosurgery, The First Affiliated Hospital of Anhui Medical University, Hefei, Anhui, People’s Republic of China;3 Nerve Injury and Repair Center of Beijing Institute for Brain Disorders, Capital Medical University, Beijing, People’s Republic of China;4 Neurotrauma Laboratory, Beijing Neurosurgical Institute, Capital Medical University, Beijing, People’s Republic of China;5 China National Clinical Research Center for Neurological Diseases, Capital Medical University, Beijing, People’s Republic of China
,
Guozhuan Miao6 Department of Neurotrauma, General Hospital of Armed Police Forces, Capital Medical University, Beijing, People’s Republic of China
,
Shuyu Hao2 Department of Neurosurgery, Beijing Tian Tan Hospital, Capital Medical University, Beijing, People’s Republic of China;3 Nerve Injury and Repair Center of Beijing Institute for Brain Disorders, Capital Medical University, Beijing, People’s Republic of China;4 Neurotrauma Laboratory, Beijing Neurosurgical Institute, Capital Medical University, Beijing, People’s Republic of China;5 China National Clinical Research Center for Neurological Diseases, Capital Medical University, Beijing, People’s Republic of China
,
Xiaogang Tao2 Department of Neurosurgery, Beijing Tian Tan Hospital, Capital Medical University, Beijing, People’s Republic of China;3 Nerve Injury and Repair Center of Beijing Institute for Brain Disorders, Capital Medical University, Beijing, People’s Republic of China;4 Neurotrauma Laboratory, Beijing Neurosurgical Institute, Capital Medical University, Beijing, People’s Republic of China;5 China National Clinical Research Center for Neurological Diseases, Capital Medical University, Beijing, People’s Republic of China
,
Zonggang Hou2 Department of Neurosurgery, Beijing Tian Tan Hospital, Capital Medical University, Beijing, People’s Republic of China;3 Nerve Injury and Repair Center of Beijing Institute for Brain Disorders, Capital Medical University, Beijing, People’s Republic of China;4 Neurotrauma Laboratory, Beijing Neurosurgical Institute, Capital Medical University, Beijing, People’s Republic of China;5 China National Clinical Research Center for Neurological Diseases, Capital Medical University, Beijing, People’s Republic of China
,
Huan Li2 Department of Neurosurgery, Beijing Tian Tan Hospital, Capital Medical University, Beijing, People’s Republic of China;3 Nerve Injury and Repair Center of Beijing Institute for Brain Disorders, Capital Medical University, Beijing, People’s Republic of China;4 Neurotrauma Laboratory, Beijing Neurosurgical Institute, Capital Medical University, Beijing, People’s Republic of China;5 China National Clinical Research Center for Neurological Diseases, Capital Medical University, Beijing, People’s Republic of China
,
Runfa Tian2 Department of Neurosurgery, Beijing Tian Tan Hospital, Capital Medical University, Beijing, People’s Republic of China;3 Nerve Injury and Repair Center of Beijing Institute for Brain Disorders, Capital Medical University, Beijing, People’s Republic of China;4 Neurotrauma Laboratory, Beijing Neurosurgical Institute, Capital Medical University, Beijing, People’s Republic of China;5 China National Clinical Research Center for Neurological Diseases, Capital Medical University, Beijing, People’s Republic of China
,
Hao Zhang1 Department of Neurosurgery, The First Affiliated Hospital of Anhui Medical University, Hefei, Anhui, People’s Republic of China;2 Department of Neurosurgery, Beijing Tian Tan Hospital, Capital Medical University, Beijing, People’s Republic of China;3 Nerve Injury and Repair Center of Beijing Institute for Brain Disorders, Capital Medical University, Beijing, People’s Republic of China;4 Neurotrauma Laboratory, Beijing Neurosurgical Institute, Capital Medical University, Beijing, People’s Republic of China;5 China National Clinical Research Center for Neurological Diseases, Capital Medical University, Beijing, People’s Republic of China;6 Department of Neurotrauma, General Hospital of Armed Police Forces, Capital Medical University, Beijing, People’s Republic of China
,
Te Lu2 Department of Neurosurgery, Beijing Tian Tan Hospital, Capital Medical University, Beijing, People’s Republic of China;3 Nerve Injury and Repair Center of Beijing Institute for Brain Disorders, Capital Medical University, Beijing, People’s Republic of China;4 Neurotrauma Laboratory, Beijing Neurosurgical Institute, Capital Medical University, Beijing, People’s Republic of China;5 China National Clinical Research Center for Neurological Diseases, Capital Medical University, Beijing, People’s Republic of China
,
Jun Ma7 Imaging Center of Neuroscience, Beijing Tian Tan Hospital, Capital Medical University, Beijing, People’s Republic of China
,
Xiaodong Zhang1 Department of Neurosurgery, The First Affiliated Hospital of Anhui Medical University, Hefei, Anhui, People’s Republic of China
,
Hongwei Cheng1 Department of Neurosurgery, The First Affiliated Hospital of Anhui Medical University, Hefei, Anhui, People’s Republic of China
&
Baiyun Liu2 Department of Neurosurgery, Beijing Tian Tan Hospital, Capital Medical University, Beijing, People’s Republic of China;3 Nerve Injury and Repair Center of Beijing Institute for Brain Disorders, Capital Medical University, Beijing, People’s Republic of China;4 Neurotrauma Laboratory, Beijing Neurosurgical Institute, Capital Medical University, Beijing, People’s Republic of China;6 Department of Neurotrauma, General Hospital of Armed Police Forces, Capital Medical University, Beijing, People’s Republic of ChinaCorrespondence[email protected]
 show all
Pages 1627-1633 | Published online: 22 Oct 2015
 
Sample our Medicine, Dentistry, Nursing & Allied Health journals, sign in here to start your FREE access for 14 days

Abstract

Objective

The outcome of decompressive craniectomy (DC) for severe traumatic brain injury (sTBI) patients with fixed dilated pupils (FDPs) is not clear. The objective of this study was to validate the outcome of DC in sTBI patients with FDPs.

Patients

We retrospectively collected data from 207 sTBI patients with FDPs during the time period of May 4, 2003–October 22, 2013: DC group (n=166) and conservative care (CC) group (n=41).

Measurements

Outcomes that were used as indicators in this study were mortality and favorable outcome. The analysis was based on the Glasgow Outcome Scale recorded at 6 months after trauma.

Results

A total of 49.28% patients died (39.76% [DC group] vs 87.80% [CC group]). The mean increased intracranial pressure values after admission before operation were 36.20±7.55 mmHg in the DC group and 35.59±8.18 mmHg in the CC group. After performing DC, the mean ICP value was 14.38±2.60 mmHg. Approximately, 34.34% sTBI patients with FDPs in the DC group gained favorable scores and none of the patients in the CC group gained favorable scores.

Conclusion

We found that DC plays a therapeutic role in sTBI patients with FDPs, and it is particularly important to reduce intracranial pressure as soon as possible after trauma. For the patients undergoing DC, favorable outcome and low mortality could be achieved.

Acknowledgments

This study was supported by National Natural Science Foundation of China (No 81171144, No 81471238, No 81341059, No 81371610), Beijing Nova program (No 2012033), and National Key Technology Research and Development Program of the Ministry of Science and Technology of China (2013BAI09B03).

Disclosure

The authors report no conflicts of interest in this work.

Download PDF

Related research

People also read lists articles that other readers of this article have read.

Recommended articles lists articles that we recommend and is powered by our AI driven recommendation engine.

Cited by lists all citing articles based on Crossref citations.
Articles with the Crossref icon will open in a new tab.