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CC BY-NC-ND 4.0 · Asian J Neurosurg 2018; 13(04): 1053-1056
DOI: 10.4103/ajns.AJNS_195_17
Original Article

Outcome of decompressive craniectomy in traumatic closed head injury

Altaf Laghari
Section of Neurosurgery, Aga Khan University Hospital, Karachi
,
Muhammad Bari
Section of Neurosurgery, Aga Khan University Hospital, Karachi
,
Muhammad Waqas
Section of Neurosurgery, Aga Khan University Hospital, Karachi
,
Syed Ahmed
1   Department of neurosurgery, The Aga Khan University Hospital, Karachi
,
Karim Nathani
1   Department of neurosurgery, The Aga Khan University Hospital, Karachi
,
Wardah Moazzam
1   Department of neurosurgery, The Aga Khan University Hospital, Karachi
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Objective: The aim of the current study was to observe functional outcomes of patients undergoing decompressive craniectomy (DC) for raised intracranial pressure (ICP) after blunt head injury and to assess possible predictive factors. Methodology: This study was a prospective cohort study which was conducted at Aga Khan University Hospital, Karachi over a period of 2 years (January 2015–December 2016). Adult patients, aged between 15 and 65 years of both genders undergoing DC during the study period were selected. Outcomes of DC were assessed at an interval of 3 months following injury using the Glasgow outcome score. The data were analyzed on IBM statistics SPSS version 21. Results: Seventy-two patients underwent DC for raised and refractory ICP. Glasgow Outcome Scale (GOS) at discharge, 1-month and 3-month follow-up were reported. GOS at 3-month follow-up showed 21 patients (29.2%) patients had a good recovery, moderate disability was reported in 16 patients (22.2%), and severe disability in 12 patients (16.7%), persistent vegetative state was seen in five patients (6.9%). Eighteen patients had in hospital mortality (25.0%). Tracheostomy and sphenoid fractures were found to be negative predictors of good functional outcome. Conclusions: DC is associated with an in hospital mortality of 25.0%. Favorable outcomes were seen in 51.4% patients. Tracheostomy and sphenoid fractures were negative predictors of good functional outcome. The results are comparable to international literature.

Key-words:

Decompressive craniectomy - intracranial pressure - Traumatic head injury


Publication History

Article published online:
14 September 2022

© 2018. Asian Congress of Neurological Surgeons. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

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