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2,277 results on '"Severe head injury"'

153. Medical Management of Elevated ICP

Author

Spiss, C. K., Illievich, U. M., Shimizu, T., Clifton, G., Vincent, Jean-Louis, editor, Steiner, Thorsten, editor, Hacke, Werner, editor, and Hanley, Daniel F., editor

Published
1998
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154. Morphological and Hemodynamic Evaluations by Means of Transcranial Power Doppler Imaging in Patients with Severe Head Injury

Author

Shiogai, Toshiyuki, Nagayama, K., Damrinjap, G., Saruta, K., Hara, M., Saito, I., Reulen, Hans-J., editor, Steiger, H.-J., editor, Marmarou, Anthony, editor, Bullock, Ross, editor, Avezaat, Cees, editor, Baethmann, Alexander, editor, Becker, Donald, editor, Brock, Mario, editor, Hoff, Julian, editor, Nagai, Hajime, editor, and Teasdale, Graham, editor

Published
1998
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155. Prospective Analysis of Patient Management in Severe Head Injury

Author

Study Group, Baethmann, Alexander, Lehr, D., Wirth, A., Reulen, Hans-J., editor, Steiger, H.-J., editor, Marmarou, Anthony, editor, Bullock, Ross, editor, Avezaat, Cees, editor, Baethmann, Alexander, editor, Becker, Donald, editor, Brock, Mario, editor, Hoff, Julian, editor, Nagai, Hajime, editor, and Teasdale, Graham, editor

Published
1998
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161. Cranioplasty as a surrogate marker for excellent outcome in severe head injury

Author

Shejoy P Joshua, Deepak Agrawal, GD Satyarthee, D Gupta, and S Sinha

Subjects
cranioplasty, outcome, severe head injury, Neurosciences. Biological psychiatry. Neuropsychiatry, RC321-571
Abstract

Outcome in severe head injury is difficult to assess due to lack of follow up. Operated patients who return for cranioplasty usually have the best outcome. The aim of this study was to assess outcome following severe head injury using cranioplasty as a surrogate marker. This was a retrospective study carried out from November 2008 to March 2010. All patients with severe head injury who underwent decompressive craniectomy (DC) or cranioplasty in the study period were included. Case records, imaging and follow up visit data from all patients were reviewed. Glasgow Coma Score on admission and Glasgow Outcome Score at discharge were assessed. Of the 273 patients, 84.25% (n=230) were male and 15.75% (n=43) were female. The mean age was 34.3 years (range 2-81 years SD 16.817). The mean GCS on admission was 5.615 (range 3-8, SD 1.438). The in-hospital mortality was 54% (n=149). GOS of 4 or 5 at discharge was attained in 22% (n=60) patients. Sixty five patients returned for cranioplasty during follow up. The M:F ratio (6.2:1) matched with the study cohort. However, the difference in mean age (28.815 years SD 13.396) and mean GCS on first admission of 6.323 (SD 1.393) were statistical significant. Therefore, at the very minimum, 65 patients (24%) of the study cohort had excellent outcome. In operated severe head injury patients significant number of patients (24% in our study) have excellent outcome. Also, cranioplasty can serve as a useful marker to assess outcome of operated severe head injury patients in an institution.

Published
2011

183. The influence of mild hypothermia on ICP, CPP and outcome in patients with primary and secondary brain injury

Author

Smrčka, M., Vidlák, M., Máca, K., Smrčka, V., Gál, R., Steiger, H. -J., editor, Poon, Wai S., editor, Chan, Matthew T. V., editor, Goh, Keith Y. C., editor, Lam, Joseph M. K., editor, Ng, Stephanie C. P., editor, Marmarou, Anthony, editor, Avezaat, Cees J. J., editor, Pickard, John D., editor, Czosnyka, Marek, editor, Hutchinson, Peter J. A., editor, and Katayama, Yoichi, editor

Published
2005
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184. The importance of major extracranial injuries by the decompressive craniectomy in severe head injuries

Author

Meier, U., Gräwe, A., König, A., Steiger, H. -J., editor, Poon, Wai S., editor, Chan, Matthew T. V., editor, Goh, Keith Y. C., editor, Lam, Joseph M. K., editor, Ng, Stephanie C. P., editor, Marmarou, Anthony, editor, Avezaat, Cees J. J., editor, Pickard, John D., editor, Czosnyka, Marek, editor, Hutchinson, Peter J. A., editor, and Katayama, Yoichi, editor

Published
2005
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185. Cranioplasty following decompressive craniectomy in traumatic brain injury: Experience at Level - I apex trauma centre

Author

Nowsheel Basheer, Deepak Kumar Gupta, AK Mahapatra, and Hitesh Gurjar

Subjects
Cranioplasty, decompressive craniectomy, severe head injury, Neurosciences. Biological psychiatry. Neuropsychiatry, RC321-571
Abstract

Complications after cranioplasty following decompressive craniectomy are often underreported. A review of the complications helps to suggest measures to improve the care of these patients. We provide a review of all complications of cranioplasty with autologous or synthetic materials in this article. All patients who had undergone cranioplasty following decompressive craniectomy at JPN Apex trauma centre, AIIMS from Jan 2008 till 2010 April were included in the study. Demographic data, indications for craniectomy, materials used, methods of autologous bone storage and all perioperative complications were recorded. Total 114 patients were studied. Mean duration between decompressive craniectomy and cranioplasty was 207.6 ± 28.2 days (Mean ± SD) with a range of 50 to 840 days . The overall postoperative complication rate was 23% (26/114) of which 16 patients (14 %) had to undergo reoperation after cranioplasty. Bone flap infection was the commonest accounting for 10 (62.5 %) of the reoperations. Even though considered as simple procedure, cranioplasty is associated with significant complications requiring reoperation. There was no correlation of complications or need for reoperation with type of materials, storage of the bone or timing of surgery. A seemingly smaller neurosurgical operation requires good surgical approach to minimize morbidity associated with cranioplasty.

Published
2010

197. Introduction

Author

Hayashi, Nariyuki, Dietrich, Dalton W., Hayashi, Nariyuki, and Dietrich, Dalton W.

Published
2004
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198. Post Traumatic Cerebral Oedema in Severe Head Injury is Related to Intracranial Pressure and Cerebral Perfusion Pressure but not to Cerebral Compliance

Author

U Nujaimin, A Saufi, G A. Rahman, I Badrisyah, S Sani, I Zamzuri, M Kamarul, and A Jafri

Subjects
cerebral oedema, severe head injury, intracranial pressure, cerebral perfusion pressure, cerebral compliance, Surgery, RD1-811
Abstract

This was a prospective cohort study, carried out in the Neuro Intensive Care Unit, Department of Neurosciences, Hospital Universiti Sains Malaysia, Kubang Kerian Kelantan. The study was approved by the local ethics committee and was conducted between November 2005 and September 2007 with a total of 30 patients included in the study. In our study, univariate analysis showed a statistically significant relationship between mean intracranial pressure (ICP) as well as cerebral perfusion pressure (CPP) with both states of basal cistern and the degree of diffuse injury and oedema based on the Marshall classification system. The ICP was higher while CPP and compliance were lower whenever the basal cisterns were effaced in cases of cerebral oedema with Marshall III and IV. In comparison, the study revealed lower ICP, higher mean CPP and better mean cerebral compliance if the basal cisterns were opened or the post operative CT brain scan showed Marshall I and II. These findings suggested the surgical evacuation of clots to reduce the mass volume and restoration of brain anatomy may reduce vascular engorgement and cerebral oedema, therefore preventing intracranial hypertension, and improving cerebral perfusion pressure and cerebral compliance. Nevertheless the study did not find any significant relationship between midline shifts and mean ICP, CPP or cerebral compliance even though lower ICP, higher CPP and compliance were frequently observed when the midline shift was less than 0.5 cm. As the majority of our patients had multiple and diffuse brain injuries, the absence of midline shift did not necessarily mean lower ICP as the pathology was bilateral and even when after excluding the multiple lesions, the result remained insignificant. We assumed that the CT brain scan obtained after evacuation of the mass lesion to assess the state basal cistern and classify the diffuse oedema may prognosticate the intracranial pressure and cerebral perfusion pressure thus assisting in the acute post operative management of severely head injured patients. Hence post operative CT brain scans may be done to verify the ICP and CPP readings postoperatively. Subsequently, withdrawal of sedation for neurological assessment after surgery could be done if the CT brain scan showed an opened basal cistern and Marshall I and II coupled with ICP of less than 20 mmHg.

Published
2009
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