MỘT SỐ ĐẶC ĐIỂM LÂM SÀNG, CẬN LÂM SÀNG VÀ HÌNH ẢNH CHỤP CẮT LỚP VI TÍNH BỆNH NHÂN CHẤN THƯƠNG SỌ NÃO NẶNG ĐƯỢC PHẪU THUẬT MỞ NẮP SỌ GIẢM ÁP

Abstract

Objective: To describe the clinical, paraclinical, and computed tomography (CT) characteristics of patients with severe traumatic brain injury (TBI) who were indicated for decompressive craniectomy at the time of hospital admission. Subjects and Methods: A prospective descriptive case series study was conducted on all patients with severe TBI who met the criteria for decompressive craniectomy upon admission from March 2024 to December 2024. Results: Among 160 patients included, most were male, within working age, and road traffic accidents were the predominant cause. Clinical characteristics revealed that the majority had severe trauma (Glasgow Coma Scale 6–8). Anisocoria was present in one-fourth of cases, and hemiparesis was observed in less than 20% of patients. CT scan findings at admission showed that most patients had a single lesion, predominantly cerebral contusion. Subarachnoid hemorrhage was present in nearly all cases. Over three-quarters had midline shift >5 mm, 80% showed basal cistern compression, and 60% developed new hematomas postoperatively. Factors associated with injury severity included age, presence of anisocoria, degree of midline shift, and basal cistern compression. Conclusion: Severe TBI remains a complex condition that challenges treatment decisions. Therefore, neurosurgeons must carefully evaluate the interrelated clinical, paraclinical, and imaging features, as these often present with high variability and clinical ambiguity.