title: Effects of decompressive surgery in patients with severe traumatic brain injury and bilateral non-reactive dilated pupils.
abstract: BACKGROUND
  We investigated Glasgow Coma Scale (GCS) scores, intracranial pressure (ICP) and cerebral perfusion pressure (CPP) changes, and long-term clinical outcomes in patients with severe traumatic brain injury (STBI) associated with bilateral non-reactive dilated pupils (BNDP) who underwent decompressive surgery (DS).
  
  
  METHODS
  The study group consisted of 28 patients (11 females, 17 males) with BNDP from among 147 patients who underwent DS due to STBI in our department.
  
  
  RESULTS
  The mean GCS score was 4.96±1.20 at admission and 4 preoperatively. Mean ICP in non-surviving patients after DS was higher (p<0.05). ICP decrease after DS was also higher in surviving patients than in non-surviving patients (p<0.05). The overall mortality rate was 61.02%. A GCS motor score >2 at admission was associated with lower mortality (p<0.05). Four of the surviving patients (14.28%) had a functional outcome (Glasgow Outcome Score: 4 and 5) at one year after hospital discharge.
  
  
  CONCLUSIONS
  Outcome in patients with BNDP after STBI may not always be fatal or poor. Rapid DS may increase the chance of functional survival, especially in patients with admission GCS score of 6 or 7.
authors.affiliation: Department of Neurosurgery, Akdeniz University Faculty of Medicine, Antalya, Turkey. ethemgoksu@mynet.com
authors.forename: Ethem
authors.initials: E
authors.lastname: Göksu
authors.forename: Tanju
authors.initials: T
authors.lastname: Uçar
authors.forename: Mahmut
authors.initials: M
authors.lastname: Akyüz
authors.forename: Murat
authors.initials: M
authors.lastname: Yılmaz
authors.forename: Saim
authors.initials: S
authors.lastname: Kazan
mesh_terms: D000063:Accidents, Traffic; D000293:Adolescent; D000328:Adult; D001930:Brain Injuries / Q000175:diagnosis / Q000503:physiopathology / Q000601:surgery*; D019299:Decompression, Surgical; D005260:Female; D015600:Glasgow Coma Scale; D006801:Humans; D007427:Intracranial Pressure; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D011681:Pupil Disorders / Q000209:etiology*; D012025:Reflex, Pupillary; D055815:Young Adult