title: Surgical management and outcomes of non-missile open head injury: Report of 44 cases from a single trauma centre.
abstract: OBJECTIVE
  To retrospectively analyse the surgical management and outcomes of non-missile open head injuries (NMOHI).
  
  
  METHODS
  Forty-four patients who suffered from NMOHI were included. The Glasgow outcome score (GOS), computed tomography (CT), aetiology and outcomes and complications at discharge and during a 6-month follow-up were analysed. All patients underwent debridement. Intracranial haematoma evacuation, decompressive craniectomy (DC) or replacement were performed.
  
  
  RESULTS
  Motor vehicle accident and struck by/against were the most common causes (43.2% each). At admission, 33 patients had Glasgow coma scores (GCS) > 8 and 27 of them had a GCS score of > 13. Mean follow-up was 8.7 ± 4.3 months. All patients underwent debridement, 20 underwent bone fracture replacement and 27 underwent haematoma evacuation; 11 patients underwent haematoma evacuation and DC and one had bilateral DC. Twenty-seven patients showed good recovery; 11 patients had moderate disability; three patients had severe disability; and three patients died. After 6 months, 32 patients had good recovery and the morbidity of severe disability had decreased to 13.6%. Thirteen patients developed intracranial infection. Post-traumatic epilepsy and hydrocephalus was detected in three patients. Cerebrospinal fluid fistula was found in five patients. Only one patient developed a brain abscess after 6 months.
  
  
  CONCLUSIONS
  NMOHI yielded satisfactory recovery and achieved good outcomes.
authors.affiliation: a Department of Neurosurgery , Ren Ji Hospital, School of Medicine, Shanghai Jiaotong University , Shanghai , P.R. China.
authors.forename: Lei
authors.initials: L
authors.lastname: Chen
authors.affiliation: a Department of Neurosurgery , Ren Ji Hospital, School of Medicine, Shanghai Jiaotong University , Shanghai , P.R. China.
authors.forename: Yinghui
authors.initials: Y
authors.lastname: Bao
authors.affiliation: a Department of Neurosurgery , Ren Ji Hospital, School of Medicine, Shanghai Jiaotong University , Shanghai , P.R. China.
authors.forename: Yumin
authors.initials: Y
authors.lastname: Liang
authors.affiliation: a Department of Neurosurgery , Ren Ji Hospital, School of Medicine, Shanghai Jiaotong University , Shanghai , P.R. China.
authors.forename: Yong
authors.initials: Y
authors.lastname: Wang
authors.affiliation: a Department of Neurosurgery , Ren Ji Hospital, School of Medicine, Shanghai Jiaotong University , Shanghai , P.R. China.
authors.forename: Jiyao
authors.initials: J
authors.lastname: Jiang
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D006259:Craniocerebral Trauma / Q000601:surgery*; D056424:Decompressive Craniectomy / Q000379:methods*; D005260:Female; D015600:Glasgow Coma Scale; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D014193:Trauma Centers; D016896:Treatment Outcome
keywords: Non-missile; open head injury; outcome; surgical management