title: Endoscopy-assisted cerebral falx incision via unilateral approach for treatment of dissymmetric bilateral frontal contusion.
abstract: OBJECTIVE
  To investigate the clinical features and treatment strategy of dissymmetric bilateral frontal contusion, and to summarize our experience in treating these patients by minimally invasive surgery.
  
  
  METHODS
  Over the past 3 years, we have treated a total of 31 patients with dissymmetric bilateral frontal contusion using endoscopy-assisted unilateral cerebral falx incision. Other 30 patients treated by routine bilateral approaches within the same period were taken as control.
  
  
  RESULTS
  Seventeen cases (54.8%) in the unilateral operation group survived and were in good condition, 8 (25.8%) had moderate disability, 4 (12.9%) had severe disability, 1 (3.2%) was in vegetative state, and 1 (3.2%) died. Compared with the control group, the Glasgow Outcome Scale score was not significantly different in the unilateral operation group, but the operation time, blood transfusion volume, the length of hospital stay, the incidences of mental disorder and olfactory nerve injury were greatly reduced in the unilateral operation group.
  
  
  CONCLUSIONS
  Endoscopy-assisted unilateral cerebral falx incision can shorten the operation time, reduce surgical trauma and complications in treatment of patients with dissymmetric bilateral frontal contusion. It can obviously diminish the chance of delayed intracerebral hematoma and subsequently minimize the incidences of subfalcial and centrencephalic herniation.
authors.affiliation: Neurosurgical Department, the 101st Hospital of PLA, Rescue Center of Craniocerebral Injuries of PLA, Wuxi 214044, Jiangsu Province, China.
authors.forename: Ji-Rong
authors.initials: JR
authors.lastname: Dong
authors.forename: Qin-Yi
authors.initials: QY
authors.lastname: Xu
authors.forename: Xue-Jian
authors.initials: XJ
authors.lastname: Cai
authors.forename: Biao
authors.initials: B
authors.lastname: Wang
authors.forename: Yu-Hai
authors.initials: YH
authors.lastname: Wang
authors.forename: Zhong-Hua
authors.initials: ZH
authors.lastname: Shi
authors.forename: Bing
authors.initials: B
authors.lastname: Liu
authors.forename: Sang
authors.initials: S
authors.lastname: Cai
authors.forename: Jian-Qing
authors.initials: JQ
authors.lastname: He
authors.forename: Xu
authors.initials: X
authors.lastname: Hu
mesh_terms: D001930:Brain Injuries; D003288:Contusions; D004388:Dura Mater; D004724:Endoscopy; D006801:Humans; D016896:Treatment Outcome