Abstract | OBJECTIVE: DESIGN: Retrospective cohort study. SETTINGS: Intensive care unit of a university hospital. PATIENTS: Among 816 patients with severe head trauma (Glasgow Coma Scale < or =8), 40 underwent decompressive craniectomy. After data collection, patients were divided into two groups: early and late decompressive craniectomy. An early decompressive craniectomy was performed within the first 24 hrs in patients according to the following criteria: a Glasgow Coma Scale score <6 and the existence of clinical signs of cerebral herniation (absence of pupillary reflexes), correlated with abnormalities in computed tomography scan including hematoma, appearance of diffuse or unilateral brain swelling, and/or cerebral herniation. The intracranial pressure in these patients was not measured before the decompressive craniectomy was performed. A late decompressive craniectomy (>24 hrs) was performed according to following criteria: an intractable intracranial hypertension with intracranial pressure >35 mm Hg, a unilateral or bilateral absence of pupillary reflexes, and the same abnormalities in computed tomography scan as previously described. INTERVENTION: MEASUREMENTS AND MAIN RESULTS: CONCLUSIONS:
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Authors | Jacques Albanèse, Marc Leone, Jean-Roch Alliez, Jean-Marc Kaya, François Antonini, Bernard Alliez, Claude Martin |
Journal | Critical care medicine
(Crit Care Med)
Vol. 31
Issue 10
Pg. 2535-8
(Oct 2003)
ISSN: 0090-3493 [Print] United States |
PMID | 14530763
(Publication Type: Journal Article)
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Topics |
- Adult
- Brain Injuries
(classification, complications, surgery)
- Craniotomy
- Decompression, Surgical
- Female
- Glasgow Coma Scale
- Humans
- Injury Severity Score
- Intensive Care Units
- Intracranial Hypertension
(complications)
- Intracranial Pressure
- Male
- Postoperative Period
- Retrospective Studies
- Tomography, X-Ray Computed
- Treatment Outcome
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