Turkish Neurosurgery 2010 , Vol 20 , Num 3
Effect of Early Bilateral Decompressive Craniectomy on Outcome for Severe Traumatic Brain Injury
Mahmut AKYUZ1, Tanju UCAR2, Cem ACIKBAS3, Saim KAZAN4, Murat YILMAZ5, Recai TUNCER6
1,2,3,4,6Akdeniz University Faculty of Medicine Department of Neurosurgery Antalya, Turkey
5Akdeniz University Faculty of Medicine Anesthesiology and Intensive Care Unit, Antalya, Turkey
DOI : 10.5137/1019-5149.JTN.2785-09.1 AIM: Debate continues as to whether decompressive craniectomy (DC) is an effective treatment for severe traumatic brain injury (STBI). DC is mostly used as a second tier treatment option. The aim of this study was determined whether early bilateral DC is effective as a first tier treatment option in patients with STBI.

MATERIAL and METHODS: The study compared two groups. Group 1 comprised 36 STBI patients for whom control of intracranial pressure (ICP) was not achieved with conservative treatment methods according to radiological and neurological findings. These patients underwent bilateral or unilateral DC as a second tier treatment. Group 2 comprised 40 STBI patients who underwent early bilateral DC as a first tier treatment.

RESULTS: Group 2 patients had a mean better outcome than Group 1patients especially for patients with a GCS 6-8. Postoperative ICP was lower in Group 2 patients than Group 1 patients.

CONCLUSION: This study indicates that early bilateral DC can be effective for controlling ICP in STBI patients. It is likely the favorable outcome results for Group 2 patients reflects the relatively short time between trauma and surgery. Therefore, these data indicate early bilateral DC can be considered as a first tier treatment in STBI patients. Keywords : Severe traumatic brain injury, Decompressive craniectomy Intracranial pressure

Corresponding author : Mahmut Akyuz, mahmutakyuz@akdeniz.edu.tr