评估双额脑挫伤患者预后因素和确定早期手术临界容量的研究

IF 0.3 Q4 SURGERY Indian Journal of Neurosurgery Pub Date : 2023-10-12 DOI:10.1055/s-0043-1774813
Manoranjitha Kumari M, T.P. Jeyaselva Senthilkumar, Yamunadevi Ravi
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引用次数: 0

摘要

摘要目的本研究的目的是评估各种预后因素及其对双额脑挫伤患者预后的影响,确定双额脑挫伤的临界容量,并为早期手术提供建议。材料和方法:本研究是一项前瞻性研究,对金奈一家三级医院收治的250例患者进行研究。在本研究中,我们研究了计算机断层扫描(CT)对结果影响的各种结果。4 .双侧额角挤压,膝后移位,第三脑室变形,基底池完全闭塞。迟发性颅内出血的发展。所有这些因素都与最坏的结果有关,对于那些出现迟发性挫伤增加的患者,入院时挫伤的中位容量为22至32 mL,平均值为27 mL,我们建议对这类患者进行预防性手术,以防止他们因迟发性脑出血而在格拉斯哥昏迷评分(GCS)中迅速恶化。结论无论入院GCS如何,双侧额挫伤的临界容积均为27 mL,需要预防性手术干预。年龄较小和入院GCS良好是预后较好的独立预测因素。挫伤容量大于50ml的患者往往伴有不良预后。双侧额角挤压、胼胝体膝前后移位、第三脑室变形和基底池闭塞是双额脑挫伤预后不良的CT预测指标。
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A Study to Evaluate Prognostic Factors and Define a Critical Volume for Early Surgery in Patients with Bifrontal Brain Contusions
Abstract Aim The aim of this study was to evaluate various prognostic factors and their impact on the outcome of patients with bifrontal brain contusions and to define the critical volume of bifrontal brain contusions and to advice early surgery Materials and Methods This is a prospective study performed with 250 patients admitted in a tertiary care hospital in Chennai. Observations and Results In this study, we have studied the various findings in computed tomography (CT) scan brain that haves influence over the outcome. These are: Bilateral squashing of frontal horn, Posterior shift of genu, The deformation of third ventricle, The complete obliteration of basal cisterns, 5. Development of delayed intracranial hemorrhage (ICH). All these factors are associated with worst outcome and in patients those developed delayed increase in contusion volume, the median volume of contusion at the admission time ranged from 22 to 32 mL and the mean being 27 mL, we recommend prophylactic surgery in this subset of patients to prevent them from developing rapid deterioration in Glasgow coma scale (GCS) due to delayed ICH. Conclusion Critical volume of bilateral frontal contusion that warrants prophylactic surgical intervention irrespective of the admission GCS is 27 mL. Younger age and good admission GCS are independent predictors for better outcome. Patients with volume of contusion more than 50 mL are always associated with unfavorable outcome. Bilateral frontal horn squashing, anteroposterior shift of genu of corpus callosum, deformation of third ventricle, and obliteration of basal cisterns are CT predictors for poor outcome in bifrontal brain contusions.
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发文量
52
审稿时长
12 weeks
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