title: Computed tomography after decompressive craniectomy for head injury.
abstract: New findings (NF) on postoperative CTs are -occasionally found in patients who undergo surgery for traumatic brain injury (TBI). We conducted a retrospective -registry-based review of the care of 102 patients who underwent decompressive craniectomy (DC) for TBI to investigate the prognostic factors of new findings on CT early after -surgery. Of the 102 patients, the mean age was 50 years and 69.6 % were male. The overall survival was 72.5 %. The primary indication for DC included subdural hematoma in 72 (70.6 %), epidural hematoma in 17 (16.7 %), and intraparenchymal contusion in 13 (12.7 %). New findings on postoperative CTs were observed in 26 patients (25.5 %). The univariate analysis showed that a GCS score ≤8 (P = 0.012) and the absence of a basal cistern (P = 0.012) were significantly associated with NF on postoperative CT. The logistic regression analysis demonstrated that the GCS score ≤8 (P = 0.041; OR, 3.0; 95 % CI, 1.048-8.517) was the only significant factor. TBI patients with a low GCS score who underwent DC should undergo additional CT evaluations immediately after surgery.
authors.affiliation: Department of Neurosurgery, National Defense Medical College, Saitama, Japan. s.takeuchi@room.ocn.ne.jp
authors.forename: Satoru
authors.initials: S
authors.lastname: Takeuchi
authors.forename: Yoshio
authors.initials: Y
authors.lastname: Takasato
authors.forename: Go
authors.initials: G
authors.lastname: Suzuki
authors.forename: Takuya
authors.initials: T
authors.lastname: Maeda
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Masaoka
authors.forename: Takanori
authors.initials: T
authors.lastname: Hayakawa
authors.forename: Naoki
authors.initials: N
authors.lastname: Otani
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Yatsushige
authors.forename: Keigo
authors.initials: K
authors.lastname: Shigeta
authors.forename: Toshiya
authors.initials: T
authors.lastname: Momose
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D006259:Craniocerebral Trauma / Q000000981:diagnostic imaging* / Q000401:mortality / Q000601:surgery*; D056424:Decompressive Craniectomy / Q000379:methods*; D005260:Female; D015600:Glasgow Coma Scale; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome; D055815:Young Adult