Abstract

Abstract

BACKGROUND: decompressive craniectomy alleviates intracranial pressure allows brain tissue to expand without diminishing edema.

OBJECTIVES: assess the effects of decompressive craniectomy alone with decompressive craniectomy with cisternostomy on the Glasgow Coma Scale in cases with severe brain trauma.

METHODS: A prospective randomized cohort research involving 40 patients with severe brain trauma was conducted from August 2022 to February 2023, with data collected from a neurosurgical teaching hospital. All patients exhibit brain trauma accompanied by a diminished Glasgow Coma Scale score. Decompressive craniectomy, with or without cisternostomy, aimed to eliminate underlying disease or hematoma and reduce intracranial pressure.

RESULTS: A research including 40 patients. In the post-operative assessment, the Glasgow Coma Scale for the Decompressive Craniectomy group recorded 8 cases with a score below 7, while the Decompressive Craniectomy with Cisternostomy group had 4 cases. the Decompressive Craniectomy group exhibited 12 cases with scores from 8 to 15, compared to 16 cases in the Decompressing Craniectomy with Cisternostomy group. About duration of assisted ventilation is shorter in patients who underwent decompressive craniectomy and cisternostomy, with 12 instances requiring less than one week and 8 cases requiring one to two weeks. only 2 cases of decompressive craniectomy required ventilation for less than one week, 18 cases required it for more than one week. In the Decompressive Craniectomy group, 8 out of 20 cases survived, resulting in a survival rate of 40%. in the Decompressive Craniectomy group, 15 out of 20 cases survived, yielding a survival rate of 75%.

CONCLUSION: the therapy of patients with severe brain trauma through decompressive craniectomy with cisternostomy enhances Glasgow Coma Scale scores of patients.

Key words: cisternostomy ,hemicraniectomy, decompressive craniectomy, severe brain trauma.