title: Do traumatic brain contusions increase in size after decompressive craniectomy?
abstract: Hemorrhagic contusions (HC) represent a common consequence of traumatic brain injury (TBI) and usually evolve during the first 12 h after trauma. The relationship between decompressive craniectomy (DC) and evolution of the post-traumatic HC is still unclear. The aim of the present study was to evaluate the impact of DC on HC evolution. Fifty-seven patients with the evidence of at least one HC at admission CT scan were analyzed. Twenty-five patients (Group 1) underwent DC and 32 patients underwent medical therapy alone (Group 2). Fisher's exact test was used to compare categorical variables. Logistic regression model was used to assess the independent contribution of predictive factors (age, ≤50 years; treatment received, DC vs. medical; anticoagulant/antiplatelet drugs intake; Rotterdam CT score, 1-3 vs. 4-6) to the evolution/new appearance of an HC. A significant increase (≥2 cc) of any HC during the observation period was detected in 8 patients (14%): 4/25 patients (16%) of Group 1 and 4/32 patients (12.5%) of Group 2 (Fisher exact test two-sided p=0.72). Univariate and multivariate analyses showed that none of the analyzed factors was associated with increased or de novo appearance of any HC. DC does not seem to constitute a risk factor for the evolution of HC.
authors.affiliation: Institute of Neurosurgery, Catholic University School of Medicine, Rome, Italy.
authors.forename: Carmelo Lucio
authors.initials: CL
authors.lastname: Sturiale
authors.forename: Pasquale
authors.initials: P
authors.lastname: De Bonis
authors.forename: Luigi
authors.initials: L
authors.lastname: Rigante
authors.forename: Rosalinda
authors.initials: R
authors.lastname: Calandrelli
authors.forename: Sonia
authors.initials: S
authors.lastname: D'Arrigo
authors.forename: Angelo
authors.initials: A
authors.lastname: Pompucci
authors.forename: Annunziato
authors.initials: A
authors.lastname: Mangiola
authors.forename: Gabriella
authors.initials: G
authors.lastname: D'Apolito
authors.forename: Cesare
authors.initials: C
authors.lastname: Colosimo
authors.forename: Carmelo
authors.initials: C
authors.lastname: Anile
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001921:Brain / Q000473:pathology*; D001930:Brain Injuries / Q000473:pathology* / Q000601:surgery*; D019299:Decompression, Surgical; D056424:Decompressive Craniectomy / Q000379:methods*; D005260:Female; D015600:Glasgow Coma Scale; D006801:Humans; D020300:Intracranial Hemorrhages / Q000209:etiology / Q000473:pathology; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D019635:Neurosurgical Procedures / Q000379:methods*; D014057:Tomography, X-Ray Computed; D055815:Young Adult