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Published on: August 5, 2014
Treatment for severe craniocerebral trauma combined with transtentorial hernia in children
Yi-Hu Liang1, Jie-Wen Mai, Lin-Fan Li
1Department of Neurosurgery, People's Hospital of Gaozhou City, Gaozhou 525200, Guangdong Province, China. liangyihu@163.net
Insights
This study explored a surgical technique for severe craniocerebral trauma with transtentorial hernia in children. Evacuating hematomas and incising the tentorium effectively reduced disability and mortality rates.
Area of Science:
- Neurosurgery
- Pediatric Traumatology
- Critical Care Medicine
Background:
- Severe craniocerebral trauma in children often presents with life-threatening complications such as transtentorial herniation.
- Effective surgical management is crucial to improve outcomes and reduce mortality in pediatric neurotrauma patients.
Purpose of the Study:
- To evaluate the efficacy of a specific surgical approach for severe craniocerebral trauma combined with transtentorial hernia in pediatric patients.
- To assess the impact of this treatment on neurological recovery, disability, and mortality rates.
Main Methods:
- A cohort of 58 pediatric patients with severe craniocerebral trauma and transtentorial hernia were treated.
- The surgical technique involved hematoma evacuation, tentorium incision, and preservation of a floating bone flap.
- Data were collected on patient Glasgow Coma Scale (GCS) scores and post-treatment outcomes.
Main Results:
- Patients presented with GCS scores ranging from 3-5 (17 cases) and 6-8 (41 cases).
- A significant majority, 79.30% (46 patients), achieved good recovery.
- Mortality rate was 6.90% (4 patients), with low rates of severe disability (1.72%) and vegetative state (1.72%).
Conclusions:
- The surgical strategy of hematoma evacuation and tentorium incision is an effective treatment for pediatric severe craniocerebral trauma with transtentorial hernia.
- This approach significantly decreases disability and mortality rates.
- Preserving the skull, avoiding cranioplasty, and reducing patient burden are additional benefits.
Objective:
To explore the treating method for severe craniocerebral trauma combined with transtentorial hernia in children.
Methods:
We treated 58 children with severe craniocerebral trauma combined with transtentorial hernia through evacuating the hematomas, incising the tentorium but preserving the floating bone flap between January 1996 and January 2002.
Results:
GCS was 3-5 in 17 cases and 6-8 in 41 cases. After treatment, 46 patients (79.30%) recovered well, 6 (10.30%) suffered from mild disability, 1 (1.72%) suffered from severe disability, 1 (1.72%) was in vegetative state, and 4 (6.90%) died.
Conclusions:
Evacuating hematomas and incising tentorium can effectively treat the child patients with severe craniocerebral trauma combined with transtentorial hernia, which can decrease the disability and mortality rates greatly, preserve the skull, exempt reoperation for cranioplasty and relieve the psychologic and physiologic burden of the child patients.
