gms | German Medical Science

63. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC)
Joint Meeting mit der Japanischen Gesellschaft für Neurochirurgie (JNS)

Deutsche Gesellschaft für Neurochirurgie (DGNC) e. V.

13. - 16. Juni 2012, Leipzig

Impact of shearing injury (SI) in patients with severe traumatic brain injury and decompressive craniectomy on outcome

Meeting Abstract

  • V. Borger - Klinik für Neurochirurgie, Johann Wolfgang Goethe-Universität, Frankfurt am Main
  • P. Schuss - Klinik für Neurochirurgie, Johann Wolfgang Goethe-Universität, Frankfurt am Main
  • H. Vatter - Klinik für Neurochirurgie, Johann Wolfgang Goethe-Universität, Frankfurt am Main
  • V. Seifert - Klinik für Neurochirurgie, Johann Wolfgang Goethe-Universität, Frankfurt am Main
  • E. Güresir - Klinik für Neurochirurgie, Johann Wolfgang Goethe-Universität, Frankfurt am Main

Deutsche Gesellschaft für Neurochirurgie. Japanische Gesellschaft für Neurochirurgie. 63. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC), Joint Meeting mit der Japanischen Gesellschaft für Neurochirurgie (JNS). Leipzig, 13.-16.06.2012. Düsseldorf: German Medical Science GMS Publishing House; 2012. DocDO.17.02

DOI: 10.3205/12dgnc154, URN: urn:nbn:de:0183-12dgnc1540

Veröffentlicht: 4. Juni 2012

© 2012 Borger et al.
Dieser Artikel ist ein Open Access-Artikel und steht unter den Creative Commons Lizenzbedingungen (http://creativecommons.org/licenses/by-nc-nd/3.0/deed.de). Er darf vervielfältigt, verbreitet und öffentlich zugänglich gemacht werden, vorausgesetzt dass Autor und Quelle genannt werden.


Gliederung

Text

Objective: Shearing injury (SI) is a known predictor for poor outcome in patients with traumatic brain injury (TBI). In the subset of severely injured patients, who underwent decompressive craniectomy (DC), the role of SI on outcome is unknown. We therefore analyzed the occurrence of DAI and its impact on functional outcome of TBI patients treated with DC.

Methods: 50 patients, who were treated with DC after severe TBI underwent magnetic resonance imaging (MRI) scanning. Patients were stratified into 4 groups: without SI lesions (A), patients with SI in the lobar white matter (B), lesions in the corpus callosum (C), lesions in the brainstem (D). Outcome was assessed according to the modified Rankin Scale (mRS) after 6 months (mRS 0–2 favourable vs. mRS 3–6 unfavourable).

Results: Mean age was 26 years. One patient died due to lethal infection. Lesions attributed to SI on MRI scans were present in 35 patients (71%). 11 patients (22%) were assigned to group B, 15 patients (31%) to group C, and 9 patients (18%) to group D. A favourable outcome was achieved in 50% of patients in group A, in 55% in group B, in 40% in group C, and in 0% in group D.

Conclusions: The occurrence of SI, especially in the brainstem, is associated with poor outcome. Therefore, MRI may be helpful in making decisions during the treatment course of TBI patients treated with DC.