gms | German Medical Science

63rd Annual Meeting of the German Society of Neurosurgery (DGNC)
Joint Meeting with the Japanese Neurosurgical Society (JNS)

German Society of Neurosurgery (DGNC)

13 - 16 June 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

Published: June 4, 2012

© 2012 Borger et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by-nc-nd/3.0/deed.en). You are free: to Share – to copy, distribute and transmit the work, provided the original author and source are credited.


Outline

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.