The Role of Temporal Lobectomy as a Part of Surgical Resuscitation in Patients with Severe Traumatic Brain Injury.
Decompressive craniectomy
neurosurgical resuscitation
severe traumatic brain injury
temporal lobectomy
Journal
Asian journal of neurosurgery
ISSN: 1793-5482
Titre abrégé: Asian J Neurosurg
Pays: India
ID NLM: 101564712
Informations de publication
Date de publication:
Historique:
entrez:
31
5
2019
pubmed:
31
5
2019
medline:
31
5
2019
Statut:
ppublish
Résumé
Traumatic brain injuries (TBIs) are serious morbidity and mortality risk for especially in the young population. Primary and secondary injury mechanisms may cause cerebral edema and intracranial hypertension. The target point of the TBI treatment is lowering the intracranial pressure medically or surgically if indicated. The files of the patients with severe brain injury admitted between January 2015 and December 2017 were reviewed retrospectively. Patients who underwent decompression surgery due to severe brain injury ([The Glasgow Coma Scale [GCS] score] <8) and additional temporal lobectomy were included in the study group. Ten patients were included in the study during the 3 years. All the patients were suffering from blunt severe TBI. Traumatic etiology was vehicle traffic accident in six cases, nonvehicle traffic accident in two cases, and falling from height in two cases. All the cases suffered from blunt trauma. The admission GCS of the patients was 4-7 (mean = 5.5). Right-sided decompression surgery and lobectomy were performed for seven patients and left-sided in three cases. The postoperational survival was 60%. All the survivors were functionally independent with mild cognitive disturbances. Temporal lobectomy might be added to the surgery to apply all the interventions available in combat with progressively increasing intracerebral pressure as a part of surgical resuscitation.
Sections du résumé
BACKGROUND
BACKGROUND
Traumatic brain injuries (TBIs) are serious morbidity and mortality risk for especially in the young population. Primary and secondary injury mechanisms may cause cerebral edema and intracranial hypertension. The target point of the TBI treatment is lowering the intracranial pressure medically or surgically if indicated.
METHODS
METHODS
The files of the patients with severe brain injury admitted between January 2015 and December 2017 were reviewed retrospectively. Patients who underwent decompression surgery due to severe brain injury ([The Glasgow Coma Scale [GCS] score] <8) and additional temporal lobectomy were included in the study group.
RESULTS
RESULTS
Ten patients were included in the study during the 3 years. All the patients were suffering from blunt severe TBI. Traumatic etiology was vehicle traffic accident in six cases, nonvehicle traffic accident in two cases, and falling from height in two cases. All the cases suffered from blunt trauma. The admission GCS of the patients was 4-7 (mean = 5.5). Right-sided decompression surgery and lobectomy were performed for seven patients and left-sided in three cases. The postoperational survival was 60%. All the survivors were functionally independent with mild cognitive disturbances.
CONCLUSION
CONCLUSIONS
Temporal lobectomy might be added to the surgery to apply all the interventions available in combat with progressively increasing intracerebral pressure as a part of surgical resuscitation.
Identifiants
pubmed: 31143259
doi: 10.4103/ajns.AJNS_240_18
pii: AJNS-14-436
pmc: PMC6516022
doi:
Types de publication
Journal Article
Langues
eng
Pagination
436-439Déclaration de conflit d'intérêts
There are no conflicts of interest.
Références
Br J Neurosurg. 1998 Aug;12(4):349-52
pubmed: 10070429
Am Surg. 2002 Dec;68(12):1066-71
pubmed: 12516810
Pediatr Crit Care Med. 2003 Jul;4(3 Suppl):S65-7
pubmed: 12847353
J Formos Med Assoc. 1992 Jan;91(1):24-8
pubmed: 1352330
J Neurotrauma. 2005 Jun;22(6):623-8
pubmed: 15941372
Neurosurgery. 2006 Mar;58(3 Suppl):S16-24; discussion Si-iv
pubmed: 16710968
J Trauma. 2007 Nov;63(5):1010-3
pubmed: 17993944
Neurosurgery. 1991 Jul;29(1):62-6
pubmed: 1870689
J Neurotrauma. 2008 Nov;25(11):1347-54
pubmed: 19061378
Crit Care. 2009;13(6):R185
pubmed: 19930556
Turk Neurosurg. 2010 Jul;20(3):382-9
pubmed: 20669113
N Engl J Med. 2011 Apr 21;364(16):1493-502
pubmed: 21434843
J Trauma. 2011 Aug;71(2):364-73; discussion 373-4
pubmed: 21825940
J Neurosurg Sci. 2014 Dec;58(4):249-59
pubmed: 25418276
Neurosurgery. 2017 Jan 01;80(1):6-15
pubmed: 27654000
J Formos Med Assoc. 1995 Jun;94(6):341-5
pubmed: 7549554
Neurosurgery. 1994 Apr;34(4):628-32; discussion 632-3
pubmed: 8008159
Acta Neurochir (Wien). 1997;139(4):286-94
pubmed: 9202767