Complications induced by decompressive craniectomies after traumatic brain injury.
OBJECTIVE
To find out the optimal approach to decompress externally the severe injured brain and to avoid possible complications caused by external decompression.


METHODS
68 patients who underwent external decompression after traumatic brain injury were admitted into Tianjin Medical University General Hospital for cranioplasty from 1995 to 2001. Complications were retrospectively investigated and analyzed in all patients. The findings were compared between the patients who accepted the decompressive craniectomy in our hospital and in local hospitals. chi(2)-test was employed for statistical analysis and complication evaluation.


RESULTS
Large craniectomy definitely caused some side effects to patients. Among various complications, several of them showed significantly high incidence (P<0.05) in patients who underwent the decompressive operation in local hospitals such as shunt-dependent hydrocephalous, subdural fluid collection, and CSF leakage from scalp incision. The rest of the complications had no remarkable difference (P<0.05) between the two groups including dilation or/and migration of lateral ventricle underlying the cranial defect, skin flap concavity, encephalomalacia of the decompressive area, seizure and infection.


CONCLUSIONS
To reduce the incidence of iatrogenic side effects, surgical craniectomy should be performed according to the strict indication and standard and any abuse should be avoided.
Yang
Xue-Jun
XJ
Department of Neurosurgery, Tianjin Medical University General Hospital, Tianjin 300052, China. xjyang@public.tpt.tj.cn
Hong
Guo-Liang
GL
Su
Shao-Bo
SB
Yang
Shu-Yuan
SY
D000293:Adolescent; D000328:Adult; D016009:Chi-Square Distribution; D006259:Craniocerebral Trauma / Q000601:surgery*; D003399:Craniotomy / Q000009:adverse effects* / Q000592:standards; D019299:Decompression, Surgical / Q000009:adverse effects* / Q000592:standards; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000453:epidemiology; D016896:Treatment Outcome