gms | German Medical Science

55. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie e. V. (DGNC)
1. Joint Meeting mit der Ungarischen Gesellschaft für Neurochirurgie

Deutsche Gesellschaft für Neurochirurgie (DGNC) e. V.

25. bis 28.04.2004, Köln

Prognosis of outcome after decompressive craniectomies in 100 brain injured patient

Klinische und radiologische Prädiktoren des Behandlungsergebnisses nach Dekompressionsoperation bei 100 hirnverletzten Patienten

Meeting Abstract

  • corresponding author Dieter H. Woischneck - Neurochirurgische Klinik, Universitätsklinikum Magdeburg, Magdeburg
  • J. Wagener - Neurochirurgische Klinik, Universitätsklinikum Magdeburg, Magdeburg
  • I. Peters - Institut für Biomedizin und Medizinische Statistik, Universitätsklinikum Magdeburg, Magdeburg
  • S. Reissberg - Klinik für Diagnostische Radiologie, Universitätsklinikum Magdeburg, Magdeburg
  • C. Grimm - Neurochirurgische Klinik, Universitätsklinikum Magdeburg, Magdeburg
  • R. Firsching - Neurochirurgische Klinik, Universitätsklinikum Magdeburg, Magdeburg

Deutsche Gesellschaft für Neurochirurgie. Ungarische Gesellschaft für Neurochirurgie. 55. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie e.V. (DGNC), 1. Joint Meeting mit der Ungarischen Gesellschaft für Neurochirurgie. Köln, 25.-28.04.2004. Düsseldorf, Köln: German Medical Science; 2004. DocP 07.77

The electronic version of this article is the complete one and can be found online at: http://www.egms.de/en/meetings/dgnc2004/04dgnc0360.shtml

Published: April 23, 2004

© 2004 Woischneck 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

Predictors of outcome after decompressive craniectomy (DC) in brain injured patients might clarify the indication for the procedure in individual cases. These are the results from a prospective study on DC.

Methods

We report prospective data from 100 patients in coma after brain injury, leading to decompressive craniectomy. Statistics were performed by use of the software package SPSS 11.0 for Windows 2000. Predictor quality was assumed for p < 0,01.

Results

Predictive value was proven for: CT findings prior to surgery (absence of any intracranial hematoma under 1cm, brain stem lesion, infarction of a. cerebri posterior, absence of basal cisterns), CT findings within 24 hours after DC (midline shift > 1cm, no visualization of external gyri, compression or absence of basal cisterns, infarctions in any territory) and clinical findings 24 hours after DC (bilaterally fixed pupils, anisocoria unchanged).

Conclusions

Coma grade prior to surgery and CT findings immediately before and within 24 hours after craniectomy are of significant predictive value. The benefit from DC will therefore be higher in lower coma grades and better neurological findings than in the deeply comatose patient.