Institute of Neurosurgery, Catholic University School of Medicine, Rome, Italy.
J Neurotrauma. 2012 Dec 10;29(18):2723-6. doi: 10.1089/neu.2012.2556. Epub 2012 Nov 9.
Hemorrhagic contusions (HC) represent a common consequence of traumatic brain injury (TBI) and usually evolve during the first 12 h after trauma. The relationship between decompressive craniectomy (DC) and evolution of the post-traumatic HC is still unclear. The aim of the present study was to evaluate the impact of DC on HC evolution. Fifty-seven patients with the evidence of at least one HC at admission CT scan were analyzed. Twenty-five patients (Group 1) underwent DC and 32 patients underwent medical therapy alone (Group 2). Fisher's exact test was used to compare categorical variables. Logistic regression model was used to assess the independent contribution of predictive factors (age, ≤50 years; treatment received, DC vs. medical; anticoagulant/antiplatelet drugs intake; Rotterdam CT score, 1-3 vs. 4-6) to the evolution/new appearance of an HC. A significant increase (≥2 cc) of any HC during the observation period was detected in 8 patients (14%): 4/25 patients (16%) of Group 1 and 4/32 patients (12.5%) of Group 2 (Fisher exact test two-sided p=0.72). Univariate and multivariate analyses showed that none of the analyzed factors was associated with increased or de novo appearance of any HC. DC does not seem to constitute a risk factor for the evolution of HC.
出血性挫伤（HC）是创伤性脑损伤（TBI）的常见后果，通常在创伤后 12 小时内发展。去骨瓣减压术（DC）与创伤后 HC 的演变之间的关系尚不清楚。本研究旨在评估 DC 对 HC 演变的影响。分析了 57 名入院 CT 扫描至少有一处 HC 的患者。25 名患者（组 1）接受了 DC，32 名患者仅接受了药物治疗（组 2）。Fisher 确切检验用于比较分类变量。逻辑回归模型用于评估预测因素（年龄，≤50 岁；治疗方法，DC 与药物治疗；抗凝/抗血小板药物使用；鹿特丹 CT 评分，1-3 与 4-6）对 HC 演变/新出现的独立贡献。在观察期间，8 名患者（14%）发现任何 HC 显著增加（≥2 cc）：组 1 中有 4/25 名患者（16%），组 2 中有 4/32 名患者（12.5%）（Fisher 确切检验双侧 p=0.72）。单因素和多因素分析表明，分析的因素均与任何 HC 的增加或新出现无关。DC 似乎不是 HC 演变的危险因素。
