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

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

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Edith Natalia Hemández Segura

Abstract

Objective: to identify the clinical features of patients who undergo decompressive craniectomy as part of the mana­ gement of traumatic brain injury (TBI). Methods: a case series of patients who underwent this procedure between January 2005 and December 2010 at Hospital de San José, Bogotá DC. The variables studied were: age, gender, Glasgow Coma Scale seores when the decompressive craniectomy was performed, Marshall classification, comorbidities, inotropic or vasopressor suppm:t required, thiopental barbiturate-induced coma, externa! ventriculostomy for controlling intracranial pressure before or at the time the craniectomy is performed, implantation of an ascendant jugular catheter and type of decompressive craniectomy conducted. Conclusion: a Coma Glasgow Scale of 3 to 6 with a Marshall classification of IV on hospital admission indicates a poor prognosis even if a decompressive craniectomy is performed within the first six hours after TBI. A rigorous control of a patient with this condition is essential to provide a prompt diagnosis and appropriate management.

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