Cargando…

Late decompressive craniectomyafter traumatic brain injury: neurological outcome at 6 months after ICU discharge

INTRODUCTION: The choice of optimal treatment in traumatic brain injured (TBI) patients is a challenge. The aim of this study was to verify the neurological outcome of severe TBI patients treated with decompressive craniectomy (early < 24 h, late > 24 h), compared to conservative treatment, in...

Descripción completa

Detalles Bibliográficos
Autores principales: Cianchi, Giovanni, Bonizzoli, Manuela, Zagli, Giovanni, di Valvasone, Simona, Biondi, Simona, Ciapetti, Marco, Perretta, Lucia, Mariotti, Furio, Peris, Adriano
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2012
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3489798/
https://www.ncbi.nlm.nih.gov/pubmed/22867014
http://dx.doi.org/10.1186/1752-2897-6-8
_version_ 1782248785778311168
author Cianchi, Giovanni
Bonizzoli, Manuela
Zagli, Giovanni
di Valvasone, Simona
Biondi, Simona
Ciapetti, Marco
Perretta, Lucia
Mariotti, Furio
Peris, Adriano
author_facet Cianchi, Giovanni
Bonizzoli, Manuela
Zagli, Giovanni
di Valvasone, Simona
Biondi, Simona
Ciapetti, Marco
Perretta, Lucia
Mariotti, Furio
Peris, Adriano
author_sort Cianchi, Giovanni
collection PubMed
description INTRODUCTION: The choice of optimal treatment in traumatic brain injured (TBI) patients is a challenge. The aim of this study was to verify the neurological outcome of severe TBI patients treated with decompressive craniectomy (early < 24 h, late > 24 h), compared to conservative treatment, in hospital and after 6-months. METHODS: A total of 186 TBI patients admitted to the ICU of the Emergency Department of a tertiary referral center (Careggi Teaching Hospital, Florence, Italy) from 2005 through 2009 were retrospectively studied. Patients treated with decompressive craniectomy were divided into 2 groups: “early craniectomy group” (patients who underwent to craniectomy within the first 24 hours); and “late craniectomy group” (patients who underwent to craniectomy later than the first 24 hours). As a control group, patients whose intracranial hypertension was successfully controlled by medical treatment were included in the “no craniectomy group”. RESULTS: Groups included 41 patients who required early decompressive craniectomy, 21 patients treated with late craniectomy (7.7 days after trauma, on average), and 124 patients for whom intracranial hypertension was successfully controlled through conservative treatment. Groups were comparable in age and trauma/critical illness scores, except for a significantly higher Marshall score in early craniectomized patients. The Glasgow Outcome Scale was comparable between groups at ICU, at the time of hospital discharge and at 6 months. CONCLUSIONS: In our sample, a late craniectomy in patients with refractory intracranial hypertension produced a comparable 6-months neurological outcome if compared to patients responder to standard treatment. This data must be reproduced and confirmed before considering as goal-treatment in refractory intracranial hypertension.
format Online
Article
Text
id pubmed-3489798
institution National Center for Biotechnology Information
language English
publishDate 2012
publisher BioMed Central
record_format MEDLINE/PubMed
spelling pubmed-34897982012-11-06 Late decompressive craniectomyafter traumatic brain injury: neurological outcome at 6 months after ICU discharge Cianchi, Giovanni Bonizzoli, Manuela Zagli, Giovanni di Valvasone, Simona Biondi, Simona Ciapetti, Marco Perretta, Lucia Mariotti, Furio Peris, Adriano J Trauma Manag Outcomes Research INTRODUCTION: The choice of optimal treatment in traumatic brain injured (TBI) patients is a challenge. The aim of this study was to verify the neurological outcome of severe TBI patients treated with decompressive craniectomy (early < 24 h, late > 24 h), compared to conservative treatment, in hospital and after 6-months. METHODS: A total of 186 TBI patients admitted to the ICU of the Emergency Department of a tertiary referral center (Careggi Teaching Hospital, Florence, Italy) from 2005 through 2009 were retrospectively studied. Patients treated with decompressive craniectomy were divided into 2 groups: “early craniectomy group” (patients who underwent to craniectomy within the first 24 hours); and “late craniectomy group” (patients who underwent to craniectomy later than the first 24 hours). As a control group, patients whose intracranial hypertension was successfully controlled by medical treatment were included in the “no craniectomy group”. RESULTS: Groups included 41 patients who required early decompressive craniectomy, 21 patients treated with late craniectomy (7.7 days after trauma, on average), and 124 patients for whom intracranial hypertension was successfully controlled through conservative treatment. Groups were comparable in age and trauma/critical illness scores, except for a significantly higher Marshall score in early craniectomized patients. The Glasgow Outcome Scale was comparable between groups at ICU, at the time of hospital discharge and at 6 months. CONCLUSIONS: In our sample, a late craniectomy in patients with refractory intracranial hypertension produced a comparable 6-months neurological outcome if compared to patients responder to standard treatment. This data must be reproduced and confirmed before considering as goal-treatment in refractory intracranial hypertension. BioMed Central 2012-08-06 /pmc/articles/PMC3489798/ /pubmed/22867014 http://dx.doi.org/10.1186/1752-2897-6-8 Text en Copyright ©2012 Cianchi et al.; licensee BioMed Central Ltd. http://creativecommons.org/licenses/by/2.0 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Research
Cianchi, Giovanni
Bonizzoli, Manuela
Zagli, Giovanni
di Valvasone, Simona
Biondi, Simona
Ciapetti, Marco
Perretta, Lucia
Mariotti, Furio
Peris, Adriano
Late decompressive craniectomyafter traumatic brain injury: neurological outcome at 6 months after ICU discharge
title Late decompressive craniectomyafter traumatic brain injury: neurological outcome at 6 months after ICU discharge
title_full Late decompressive craniectomyafter traumatic brain injury: neurological outcome at 6 months after ICU discharge
title_fullStr Late decompressive craniectomyafter traumatic brain injury: neurological outcome at 6 months after ICU discharge
title_full_unstemmed Late decompressive craniectomyafter traumatic brain injury: neurological outcome at 6 months after ICU discharge
title_short Late decompressive craniectomyafter traumatic brain injury: neurological outcome at 6 months after ICU discharge
title_sort late decompressive craniectomyafter traumatic brain injury: neurological outcome at 6 months after icu discharge
topic Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3489798/
https://www.ncbi.nlm.nih.gov/pubmed/22867014
http://dx.doi.org/10.1186/1752-2897-6-8
work_keys_str_mv AT cianchigiovanni latedecompressivecraniectomyaftertraumaticbraininjuryneurologicaloutcomeat6monthsaftericudischarge
AT bonizzolimanuela latedecompressivecraniectomyaftertraumaticbraininjuryneurologicaloutcomeat6monthsaftericudischarge
AT zagligiovanni latedecompressivecraniectomyaftertraumaticbraininjuryneurologicaloutcomeat6monthsaftericudischarge
AT divalvasonesimona latedecompressivecraniectomyaftertraumaticbraininjuryneurologicaloutcomeat6monthsaftericudischarge
AT biondisimona latedecompressivecraniectomyaftertraumaticbraininjuryneurologicaloutcomeat6monthsaftericudischarge
AT ciapettimarco latedecompressivecraniectomyaftertraumaticbraininjuryneurologicaloutcomeat6monthsaftericudischarge
AT perrettalucia latedecompressivecraniectomyaftertraumaticbraininjuryneurologicaloutcomeat6monthsaftericudischarge
AT mariottifurio latedecompressivecraniectomyaftertraumaticbraininjuryneurologicaloutcomeat6monthsaftericudischarge
AT perisadriano latedecompressivecraniectomyaftertraumaticbraininjuryneurologicaloutcomeat6monthsaftericudischarge