Craneotomía descompresiva en trauma craneoencefálico experiencia en el hospital de San José. Bogotá DC, Colombia

Decompressive craniectomy for traumatic brain injury experience in the hospital de San José. Bogotá DC, Colombia

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Edith Natalia Hemández Segura

Resumen

Objetivo: identificar las características clínicas de los pacientes llevados a craneotomía descompresiva como parte del manejo del trauma craneoencefálico. Métodos: serie de casos de enero 2005 a diciembre 2010 del Hospital de San José de Bogotá DC, a quienes se les efectuó el procedimiento. Las variables estudiadas fueron: edad, género, escala de coma de Glasgow al realizar la craneotomía descompresiva, escala de Marshall, comorbilidades, soporte inotrópico o vasopresor requerido, inducción de  coma barbitúrico  con tiopental,  ventriculostomía externa  para  control de la presión intracraneana antes o al momento  de realizar la craneotomía, uso de catéter yugular ascendente y tipo de craneotomía descompresiva. Conclusión: la valoración al ingreso con escala coma de Glasgow de 3 a 6, asociada con escala de Mar­ shall IV, indican mal pronóstico a pesar de realizar la craneotomía descompresiva en las primeras seis horas postrauma craneoencefálico. Se hace necesario el control riguroso del paciente con esta patología para realizar el diagnóstico y manejo oportunos.

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