9 / 11
Page 37
Journal of Neurology and Clinical Neuroscience | Volume: 03
8
th
International Conference on
NEUROLOGICAL DISORDERS,
CENTRAL NERVOUS SYSTEM AND STROKE
&
International Conference on
NEUROLOGY AND NEUROSURGERY
December 04-05, Dubai, UAE
Joint event on
J Neurol Clin Neurosci, Volume: 03
Mat r Sci Nanot chnol
Decompressive Craniectomy following severe traumatic Brain injury with an initial
Glas-gow coma scale score of 3 and 4
Afif Afif
Hospital Center of Sens, France
Background
: Decompressive craniectomy formed as
surgical management option for severe traumatic brain
injury (TBI). Few studies that follow the TBI patients with a
Glasgow coma scale (GCS) score of 3 or 4. Decompressive
craniectomy was avoided in these patients due to the poor
outcomes and the worse func-tional recovery.
Clinical Presentation
: Two patients were presented in our
case series. The first one suffered of severe TBI following
an aggression with a Glasgow coma scale (GCS) score of
3/15 and bilaterally dilated unreactive pupils. A brain CT-
scan showed right frontal fracture, bifrontal hematoma
contusion, a fronto-temporo-parietal acute subdural
hematoma (SDH) with a thickness of 14 mm on the right
side, traumatic subarach-noid hemorrhage, with 20 mm
of midline shift to the left side, diffuse brain edema.
The second one pre-sented with severe TBI following an
automobile accident with a GCS score of 4/15 and iso-
reactive pupils. A brain CT-scan showed bilateral fronto-
temporal fracture, diffuse brain hematoma contusion,
traumatic subarachnoid hemorrhage, right extradural
hematoma (EDH) and bilateral fronto-temporo-parietal
acute subdural hematoma (SDH) more important in the
right side.
Discussion and Conclusion
: Our case series suggest that
the wide adequate decompressive craniectomy in patients
with severe TBI and GCS score of 3 or 4 can be performed
and useful to obtain good long-term neurological
outcomes with a good functional recovery. The rapidity of
the surgical indication decision can be option to obtain the
better neurological outcomes.
e:
afif_acc@hotmail.com