Large bone-flap decompressive craniotomy for treatment of serious craniocerebral injury associated with cerebral infarction.

OBJECTIVE

To elucidate the therapeutic effect of subtemporal decompressive craniotomy with large flap resection on serious craniocerebral injury associated with cerebral infarction.

METHODS

Forty-eight cases of serious head injury accompanied by cerebral infarction were classified into two groups with each having 24 cases: treatment group, in which large bone-flap decompressive craniotomy was performed; control group, in which routine craniotomy and hematoma evacuation were adopted. The status of cerebral infarction pre- and post-operation, as well as the curative effect 3 months after operation were comparatively analysed between the two groups.

RESULTS

There was no significant difference regarding the status of cerebral infarction on the first day after operation; while one week after operation, the size of cerebral infarction was significantly smaller in treatment group than control one (P less than 0.05). Postoperative 3 months, the mortality rate was 20.8% in treatment group, being evidently superior to that of control group (33.3%, P less than 0.05). The mo- derate disability (good and fair) rate was 41.7% in treatment group, significantly higher than that in control group (25.0%, P less than 0.05).

CONCLUSION

Large bone-flap decompressive craniotomy is confirmed effective and hence it offers us a preferable alternative of treatment by which to reduce disability and fatality rates for patients with serious head injury accompanied by cerebral infarction.