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Related Experiment Videos

Bilateral craniotomies for blunt head trauma

N Razack1, R V Singh, D Petrin

  • 1University of Miami Department of Surgery, Jackson Memorial Medical Center, Florida, USA.

The Journal of Trauma
|December 9, 1997
PubMed
Summary

Bilateral craniotomies for severe blunt head injuries are uncommon but survivable. Patient outcomes strongly correlate with initial Glasgow Coma Scale scores, with severe injuries indicating higher mortality risks.

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Area of Science:

  • Neurosurgery
  • Trauma Surgery
  • Neurology

Background:

  • Delayed or recurrent intracranial hematomas requiring reoperation are known complications.
  • Bilateral craniotomies for initial emergency treatment of head trauma are infrequent.
  • Limited literature exists on outcomes of bilateral craniotomies for blunt head injuries.

Purpose of the Study:

  • To analyze the outcomes of patients who underwent bilateral craniotomies for blunt head injury.
  • To investigate the correlation between initial Glasgow Coma Scale scores and patient outcomes.
  • To identify factors influencing survival and functional recovery in this patient cohort.

Main Methods:

  • Retrospective analysis of 20 patients undergoing bilateral craniotomies between 1986 and 1994.

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  • Data collection included mechanism of injury, hematoma types, preoperative Glasgow Coma Scale (GCS) scores, and discharge functional status (Rancho Los Amigos Scale).
  • Statistical comparison using Fisher's exact test to evaluate the impact of GCS score severity on mortality.

    • Main Results:

    • The study included 20 patients (ages 18-85) with various blunt head injury mechanisms and hematoma types.
    • The mean preoperative GCS score was 8.8; 16 out of 20 patients survived.
    • Survivors had a mean discharge Rancho Los Amigos Scale score of 6.1; severe head injury (GCS 4-8) was associated with a statistically significant higher mortality rate (p < 0.05).

    Conclusions:

    • Bilateral craniotomy for emergency initial treatment of severe blunt head injury can lead to survival.
    • Initial Glasgow Coma Scale score is a significant predictor of mortality in patients requiring bilateral craniotomies.
    • The findings underscore the importance of early neurological assessment in guiding treatment and predicting outcomes for complex head trauma.