Research Journal of Medical Sciences
ISSN: Online 1993-6095ISSN: Print 1815-9346
Abstract
The management of raised intracranial pressure (ICP) is crucial in patients with severe traumatic brain injury (TBI). Decompressive craniotomy (DC) is a surgical procedure used to relieve brain pressure and improve outcomes in these cases. This study aimed to analyze the outcomes and complications of DC in severe TBI patients and investigate their correlation with various factors. This prospective, observational study was conducted at a tertiary care center and included 25 patients with severe TBI who underwent DC. Various demographic, clinical and radiological variables were recorded and their correlation with patient outcomes was analyzed using the Glasgow Outcome Scale (GOS). Statistical analysis was performed to determine the significance of different factors in predicting the outcome of DC. The majority of patients were males (92%) and a higher proportion of patients (56%) belonged to the age group of 15‐45 years. Road traffic accidents (RTA) were the most common cause of head injury (88%). Pupillary responses were non‐reactive in 56% of patients and 80% of patients required ventilatory support. The initial Glasgow Coma Scale (GCS) was less than 5 in 76% of cases. CT findings revealed subdural hematoma with contusion as the most common lesion (68%). Patients with non‐reactive pupils had a higher percentage of unfavorable outcomes (p = 0.047) and those with a GCS score greater than 5 had more favorable outcomes (p = 0.032). Early surgery within 8 hrs of trauma showed better outcomes compared to surgery after 8 hours (p = 0.017). Age, gender, comorbidities, midline shift, size of craniotomy and duroplasty did not show statistically significant correlations with outcomes (p>0.05). The study highlights the Patients with salvageable GCS, normal or unilateral dilated pupils and those operated on within 8 hrs of trauma had better outcomes. However the impact of comorbidities and duroplasty on outcomes was not statistically significant. Further research is required to better understand the complexities of factors influencing the outcome of decompressive craniotomy in severe traumatic brain injury. Decompressive craniotomy, severe traumatic brain injury, raised intracranial pressure, glasgow outcome scale, pupillary response, timing of surgery.
How to cite this article:
Vineet Tanwar, Gian Chand, Digvijay Singh Thakur and Biplav Singh. Decompressive Craniotomy in Traumatic Brain Injury: A Prospective Study of 25 Patients.
DOI: https://doi.org/10.36478/10.36478/makrjms.2024.5.40.46
URL: https://www.makhillpublications.co/view-article/1815-9346/10.36478/makrjms.2024.5.40.46