Pandey Sharad, Sharma Vivek, Singh Kulwant, Pandey Deepa, Sharma Mukesh, Patil Deepak Bhanudas, Shende Neeraj, Chauhan Richa Singh
Department of Neuro Surgery, Sir Sunder Lal Hospital, IMS, BHU, Varanasi, Uttar Pradesh 221005 India.
Department of General Surgery, Government Medical College, Rajindra Hospital, Patiala, Punjab India.
Indian J Surg. 2017 Feb;79(1):19-23. doi: 10.1007/s12262-015-1416-3. Epub 2015 Dec 16.
The objective of this study was to evaluate the age distribution, mode of injury, type of hematomas, and their surgical outcome in patients with bilateral traumatic head injuries. The present study included 669 cases of traumatic head injury who presented at the neurosurgery emergency out of which 94 cases had bilateral head injuries from the period of August 2009 to April 2014. The data from the hospital computerized database were retrospectively analysed. Cases of bilateral traumatic head injury included 94 patients out of which 88.29 % ( = 83) were males and 11.70 % ( = 11) were females. Commonest mode of injury was road traffic accident in 56.38 % ( = 53) followed by fall from height in 29.78 % ( = 28). In our study, 25.53 % patients had epidural hematoma (EDH) with intracerebral hematoma (ICH) or contusion ( = 24), followed by EDH with subarachnoid hemorrhage (SAH) in 18.08 % ( = 17). At the time of discharge, all those patients managed conservatively had good Glasgow outcome scale (GOS) while with surgical intervention 58 % patients had good GOS, 19 % had moderate disability, and 9 % remained with severe disability. In cases of bilateral hematomas, EDH is most common and should be managed in neurosurgical emergency. Other combinations of bilateral intracranial hematomas should be managed according to the surgical indication and serial CT imaging.
本研究的目的是评估双侧创伤性颅脑损伤患者的年龄分布、损伤方式、血肿类型及其手术结果。本研究纳入了669例在神经外科急诊就诊的创伤性颅脑损伤患者,其中94例在2009年8月至2014年4月期间发生双侧颅脑损伤。对医院计算机数据库中的数据进行回顾性分析。双侧创伤性颅脑损伤病例包括94例患者,其中88.29%(=83例)为男性,11.70%(=11例)为女性。最常见的损伤方式是道路交通事故,占56.38%(=53例),其次是高处坠落,占29.78%(=28例)。在我们的研究中,25.53%的患者有硬膜外血肿(EDH)合并脑内血肿(ICH)或挫伤(=24例),其次是硬膜外血肿合并蛛网膜下腔出血(SAH),占18.08%(=17例)。出院时,所有保守治疗的患者格拉斯哥预后评分(GOS)良好,而接受手术干预的患者中,58%的患者GOS良好,19%有中度残疾,9%仍有严重残疾。在双侧血肿的病例中,硬膜外血肿最为常见,应在神经外科急诊中进行处理。双侧颅内血肿的其他组合应根据手术指征和连续CT成像进行处理。