Surgical strategies for neurological function preservation in severe brain contusion.
OBJECTIVE
Traditional surgical strategies for severe brain contusion are constantly associated with variable degree of postoperative neurological dysfunction, which is in part attributed to the location and severity of contusion. The purpose of this study was to compare and evaluate these current surgical strategies, with an emphasis on neurological function preservation.


METHODS
A retrospective review of surgical strategies employed for 142 cases of severe brain contusion was performed. The surgical strategies were stratified into four types, Type I, Simple DC, without resection of contusion; II, Resection of contusion, combined with DC; III, Safe cerebral lobe resection and DC, without resection of contusion; IV, Simple resection of contusion, without decompression. The patients were accordingly separated into four groups.


RESULTS
The favorable prognosis rate in Group I, II and III was higher than Group IV on 6-month follow-up Glasgow Outcome Score (GOS). No significant difference of mortality rate was observed among Group I, II and III (p > 0.05), but the favorable prognosis rate of Group II was lower than Group I and III (p < 0.05).


CONCLUSIONS
Simple DC and safe cerebral lobe resection combined with DC might achieve better therapeutic effect, and could be recommended as the preferred surgical strategies for severe brain contusion.
Nanfang Hospital, Southern Medical University, Department of Neurosurgery, Guangzhou, China. qiubui@gdvnet.com
Binghui
B
Qiu
Shuxiang
S
Xu
Luxiong
L
Fang
Silky
S
Chotai
Weiguang
W
Li
Songtao
S
Qi
D000293:Adolescent; D000328:Adult; D000368:Aged; D001930:Brain Injuries / Q000000981:diagnostic imaging / Q000534:rehabilitation* / Q000601:surgery*; D002648:Child; D016208:Databases, Factual; D056424:Decompressive Craniectomy / Q000379:methods* / Q000534:rehabilitation*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000000981:diagnostic imaging / Q000534:rehabilitation; D011379:Prognosis; D020127:Recovery of Function; D012189:Retrospective Studies; D014057:Tomography, X-Ray Computed; D015599:Trauma Severity Indices; D016896:Treatment Outcome; D055815:Young Adult