When the Bone Flap Expands Like Bellows of Accordion: Feasibility Study Using Novel Technique of Expansile (Hinge) Craniotomy for Severe Traumatic Brain Injury

被引：6

作者：

Mishra, Tejesh ^{[1
]}

Kishore, Kislay ^{[1
,2
]}

Jayan, Mini ^{[4
]}

Thaploo, Divesh ^{[1
,5
]}

Shanbhag, Nagesh C. ^{[1
,6
]}

Bhat, Dhananjaya, I ^{[1
,3
,7
]}

Shukla, Dhaval P. ^{[1
,7
]}

Konar, Subhas K. ^{[1
]}

Devi, Bhagavatula, I ^{[1
,7
]}

Hutchinson, Peter J. ^{[7
,8
,9
]}

机构：

[1] Natl Inst Mental Hlth & Neurosci NIMHANS, Dept Neurosurg, Bangalore, Karnataka, India

[2] Natl Inst Mental Hlth & Neurosci NIMHANS, Dept Biostat, Bangalore, Karnataka, India

[3] RV Aster Hosp, Bangalore, Karnataka, India

[4] Univ Toronto, Div Neurosurg, St Michaels Hosp, Toronto, ON, Canada

[5] Tech Univ Dresden, Dept Otorhinolaryngol Smell & Taste Clin, Dresden, Germany

[6] Lund Univ, Biomed Ctr, Dept Expt Med Sci, Lund, Sweden

[7] Univ Cambridge, NIHR Global Hlth Res Grp Neurotrauma, Cambridge, England

[8] Univ Cambridge, Dept Clin Neurosci, Cambridge, England

[9] Addenbrookes Hosp, Dept Neurosurg, Cambridge, England

来源：

NEUROLOGY INDIA | 2021年 / 69卷 / 04期

关键词：

Decompressive craniectomy; expansile (hinge) craniotomy; Glasgow outcome scale; intracranial volume; severe traumatic brain injury;

D O I：

10.4103/0028-3886.325310

中图分类号：

Q189 [神经科学];

学科分类号：

071006 ;

摘要：

Background: Decompressive craniectomy (DC) is a rescue operation performed for reduction of intracranial pressure due to progressive brain swelling, mandating the need for cranioplasty. Objective: To describe expansile craniotomy (EC) as a noninferior technique that may be effectively utilized in situations requiring standard DC. Materials and Methods: A decision to perform DC or EC was taken by consecutively allocation to either of the procedures. The bone flap was divided into three pieces, which were tied loosely to each other and to the skull using silk threads. The primary outcome included functional assessment using Glasgow outcome scale (GOS) score at 1 year. Results and Conclusions: Total 67 patients were included in the analyses, of which, 31 underwent EC and 36 underwent DC. Both the cohorts were matched in terms of baseline determinants for age, Glasgow coma scale, and Rotterdam score at admission. There was no significant difference in GOS scores and the extent of volume expansion obtained by EC as compared to DC. Complication rates though less in EC group did not differ significantly between the groups. EC appears to be the safe and effective alternative to DC in the management of brain swelling due to TBI with a potential to obviate the need of cranioplasty.

引用

页码：973 / 978

页数：6