Gerl A, Tavan S
Zentralbl Neurochir. 1980;41(2):125-38.
The extensive bilateral craniectomy with opening of the dura offers the possibility of rapid reduction of intracranial pressure. The reactive brain edema with imminent or beginning decompensation indicates the need for operation. Technically, it is easy to carry out bilateral cranial decompression. The open dura results in no additional postoperative problem. 21 of our 30 patients died postoperatively within 8.6 days, 2 patients in state of apallic syndrome after 4 and 16 months. 2 patients are living now with apallic syndrome for 17 and 20 months. All apallic patients show a massive hydrocephalus internus. 5 patients demonstrate a full restitution. In this group there is an interval of 3.2 days between accident and operation, the duration of the postoperative unconsciousness was 9.4 days. In children a spontaneous ossification of the bone defect may be expected if the periost is conserved. The article compares the bilateral craniectomy with other conservative and operative methods of treatment.
广泛的双侧颅骨切除术并打开硬脑膜可迅速降低颅内压。伴有即将发生或开始失代偿的反应性脑水肿表明需要进行手术。从技术上讲，双侧颅骨减压很容易实施。打开硬脑膜不会导致额外的术后问题。我们的30例患者中有21例在术后8.6天内死亡，2例在4个月和16个月后处于去大脑皮质综合征状态。2例患者现患有去大脑皮质综合征，分别为17个月和20个月。所有去大脑皮质患者均表现出大量的脑室内积水。5例患者完全康复。在这组患者中，事故与手术之间的间隔为3.2天，术后昏迷持续时间为9.4天。如果保留骨膜，儿童的骨缺损可能会自发骨化。本文将双侧颅骨切除术与其他保守和手术治疗方法进行了比较。
