1. Resection of swollen temporal muscles in patients with intractable intracranial hypertension after decompressive craniectomy
- Author
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Shih-Hao Huang, Sheng-Jean Huang, Abel Po-Hao Huang, and Lu-Ting Kuo
- Subjects
medicine.medical_specialty ,Decompressive Craniectomy ,Intracranial Pressure ,medicine.medical_treatment ,Temporal Muscle ,Temporal muscle ,Epidural hematoma ,Original Article - Brain trauma ,Skull fracture ,medicine ,Humans ,Intracranial pressure ,Retrospective Studies ,business.industry ,Clinical outcome ,Head injury ,Glasgow Coma Scale ,medicine.disease ,Surgery ,Craniectomy ,Treatment Outcome ,Decompressive craniectomy ,Neurology (clinical) ,Neurosurgery ,Intracranial Hypertension ,business - Abstract
BackgroundDecompressive craniectomy is employed as treatment for traumatic brain swelling in selected patients. We discussed the effect of temporal muscle resection in patients with intractable intracranial hypertension and temporal muscle swelling after craniectomy.MethodsRecords of 280 craniectomies performed on 258 patients who were admitted with severe head injury were retrospectively reviewed. Eight patients developed intractable increased intracranial pressure with temporal muscle swelling within 24 h after craniectomy and were treated by muscle resection.ResultsThe initial Glasgow Coma Scale score was 7 ± 1. The mean intracranial pressure was 41.7 ± 8.59 mmHg before muscle resection and 14.81 ± 8.07 mmHg immediately after surgery. Five patients had skull fracture and epidural hematoma at the craniectomy site. The mean intensive care unit stay was 11.25 ± 5.99 days. Glasgow Outcome Scale-Extended scoring performed during the 12-month follow-up visit showed that 6 patients (75%) had a favorable outcome.ConclusionsOur study findings indicate that a direct impact on the temporal region during trauma may lead to subsequent temporal muscle swelling. Under certain circumstances, muscle resection can effectively control intracranial pressure.
- Published
- 2021