Clinical analysis of secondary brain damage of 54 cases after decompressive craniectomy

    XUE Yong

    Department of Neurosurgery, General Hospital of Zhongyuan Oil Field, Puyang 457001, China

    ¡¾Abstract¡¿ AIM: To study the causes of secondary brain injury and how to treat the injury after decompressive craniectomy. METHODS: Two hundred and sixtyª²seven intracranial hematoma patients with frontalª²temporal decompressive craniectomy, were divided into 3 groups according to the size of the bone window group ¢ñ, 5 cm¡Á7 cm¡Á~6 cm¡Á11 cm (n=72); group ¢ò, 7 cm¡Á12 cm~11 cm¡Á14 cm (n=103); group ¢ó 12 cm¡Á15 cm or larger. Language function and upper limb motor function opposite to the side of hematoma before and after operation were recorded and compared. RESULTS: Secondary brain damage happened in 54 of all the patients. 35.9% (37/103) patients with mediumª²sized bone window had secondary brain damage, while the incidence of secondary brain damage for patients with smaller or larger size of bone window was 10.3%(7/12) and 10.9%(10/92), respectively. No such damage was observed in those patients whose dura had been repaired. CONCLUSION: Attention should be paid to the brain damage after decompressive craniectomy. The patients with mediumª²sized bone window have a high incidence rate of secondary brain damage. Protecting the vein and bone flap above functional domain and repairing the dura are good solutions to prevent the secondary brain injury. ......