Standard large trauma craniotomy for treatment of severe traumatic brain injury:a report of 32 cases

Objective:To compare the clinical efficacy of standard large trauma craniotomy and routine temporoparietal craniectomy in treatment of severe traumatic brain injuries.Methods:Sixty-two patients with severe traumatic brain injuries were randomly divided into treatment group(n=32) and control group(n=30).The control group underwent routine craniectomy and decompressive craniectomy together with dura opening with the bone window size of 6 cm8 cm.The treatment group received large trauma craniotomy and bone disc decompression craniotomy with the bone window size of 12 cm15 cm.Epidural relaxation suture repair was performed simultaneously during the operation.The postoperative intracranial pressure,complication rate and prognosis of the two groups were compared.Results:Half a month after the operation,the incidence of 3 d continuous intracranial pressure of the treatment group was 12.5%,which was lower than that of the control group(33.3%)(P0.05).There was no significant difference in traumatic cerebral infarction,complication of brain tissue incision hernia,traumatic epilepsy and traumatic hydrocephalus between the two groups(P0.05).The recovery rate of moderate disability was 84.4% in the treatment group and 60.0% in the control group.The prognosis of the treatment group was better than that of the control group(P0.05).Conclusions:Standard large trauma craniotomy can significantly reduce the brain damage,preserve the brain function and decrease the incidences of complications.It is more effective than the routine temporoparietal craniectomy for treatment of severe traumatic brain injuries.