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SURVEYING THE RATE OF APPEARANCE OF NEW HEMATOMAS AFTER DECOMPRESSIVE CRANIECTOMY DUE TO TRAUMATIC BRAIN INJURY
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Abstract
Objectives: To determine the rate of new hematoma appearing after decompressive craniectomy in patients with traumatic brain injury, to determine the risk factors which cause new hematomas to appear after decompressive craniectomy in patients with traumatic brain injury. Methods: All patients diagnosed with acute subdural hematoma or hemorrhagic contusion or both were indicated for decompressive craniectomy since January 2017 until January 2020 at Thong Nhat hospital. A cross-sectional descriptive retrospective study with sample size calculated using a sample size calculation formula based on p as the rate of new hematoma in patients undergoing craniectomy to decompress traumatic brain injury in Kurland's study. Result: We collected 172 records that met the bove conditions and obtained the following results: The rate of new hematoma after unilateral decompressive craniectomy in TBI patients was 50.58%. And this rate occurred only for the injuredside, no progress was seen on the other side. We obtained the relevant factors such as the amount of hematoma and cerebral contusion before surgery, the occurrence of ICH, the status of the basal ganglia and the Rotterdam score associated with the formation of new hematomas after decompressive craniectomy. With an amount of hematoma and cerebral contusion before surgery can help us predict the amount of hematoma and cerebral edema after surgery. At the same time, with the appearance of IVH and the compression of basal ganglia, the possibility of that happening was even worse. Conclusion: decompressive craniectomy helped to save lives in plenty of serious conditions due to accident, but the assessment of effectiveness depends on clinical, imaging and risk factors to determine when to operate to achieve the most favorable outcome not only in the perioperative period but also in the potential of recovery.
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Keywords
decompressive craniectomy, traumatic brain injury, intraventricle hematoma, brain contusion.
References
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