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.