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Therapeutics and Clinical Risk Management Volume 11, 2015 - Issue
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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]
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Pages 1627-1633 | Published online: 22 Oct 2015

Figures & data

Table 1 Baseline characteristics of the patients

Figure 1 The mean measurements of intracranial pressure (ICP) in the two study groups 1 hour before and 7 days after treatment.

Note: The error bars indicate standard deviation.
Figure 1 The mean measurements of intracranial pressure (ICP) in the two study groups 1 hour before and 7 days after treatment.

Figure 2 The survival of patients in different groups over time.

Notes: (A) The survival of patients in different groups in one week. (B) The survival of patients in different groups in two weeks. (C) The survival of patients in different groups in six months. The deceased cases occurred within 3 days after trauma in conservative care group, among which 72.22% occurred within 24 hours; while 81.82% of the cases occurred within 1 week in the decompressive craniectomy group, in which the highest mortality (approximately 45%) was observed between 3 days and 1 week and the mortality decreased gradually after that (P<0.001).
Figure 2 The survival of patients in different groups over time.

Table 2 Mortality and survival in different treatments

Table 3 Glasgow Outcome Scale (GOS)

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