Purpose: We aimed to assess the long-term neurological outcomes and the functionality and QoL in patients undergoing decompressive craniectomy for severe traumatic brain injury, respectively.
Materials And Methods: Among the 120 patients who underwent decompressive craniectomy for severe TBI between 2002 and 2007, 101 were included based on the inclusion criteria. Long-term follow-up results (minimum 3 years) were available for 22 patients. The outcomes were assessed using the Glasgow Outcome Scale (GOS) and the functionality and HRQoL were assessed using the Short Form-36 (SF-36) (v2) and Quality of Life After Brain Injury (QoLIBRI) questionnaires.
Results: Among the patients with severe TBI, 62 (61.4%) died and 39 (38.6%) were discharged to either home or a physical therapy facility. Eleven of the thirty-nine patients could not be reached and were excluded from the final analysis. The mean GOS of the remaining 28 patients was 4.14 ± 0.8 after 6.46 ± 1.64 years of follow-up. The HRQoL was assessed in 22 of the 28 patients. The HRQoL scores were lower in patients with TBI than in healthy controls. Furthermore, there was a significant difference in the HRQoL scores in patients with improved GOS scores than in those with unimproved GOS scores.
Conclusions: Health-related outcome scores could help clinicians understand the requirements of survivors of severe TBI to create a realistic rehabilitation target for them. QoLIBRI served as a good way of communication in these subjects.
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http://dx.doi.org/10.1080/00207454.2024.2327400 | DOI Listing |
J Neurosurg Anesthesiol
November 2024
Department of Anesthesiology and Pain Medicine, University of Washington, Seattle, WA.
This systematic review aimed to identify and describe best practice for the intraoperative anesthetic management of patients undergoing emergent/urgent decompressive craniotomy or craniectomy for any indication. The PubMed, Scopus, EMBASE, and Cochrane databases were searched for articles related to urgent/emergent craniotomy/craniectomy for intracranial hypertension or brain herniation. Only articles focusing on intraoperative anesthetic management were included; those investigating surgical or intensive care unit management were excluded.
View Article and Find Full Text PDFCells
December 2024
Institute of Anaesthesiologic Pathophysiology and Process Development, University Hospital Ulm, Helmholtzstrasse 8/1, 89081 Ulm, Germany.
Traumatic brain injury (TBI) remains one of the leading causes of death. Because of the individual nature of the trauma (brain, circumstances and forces), humans experience individual TBIs. This makes it difficult to generalise therapies.
View Article and Find Full Text PDFWorld Neurosurg X
April 2024
Department of Neurosurgery and Spine Surgery, University Hospital Essen, University of Duisburg-Essen, Essen, Germany.
Background: Baseline values and the change of platelet count (PLT) during disease were reported to be associated with prognosis of patients with cancer and intensive care treatment. We aimed to evaluate the association between PLT with the course and prognosis of aneurysmal subarachnoid hemorrhage (SAH).
Methods: Admission (AdmPLT) and the 14-days mean PLT (MeanPLT) values of 763 SAH patients treated between 01/2005 and 06/2016 were recorded and, for further analysis, divided into four categories: <150, 150-260, 261-400 and > 400 × 10/L.
ANZ J Surg
January 2025
Department of Neurosurgery, Liaoyang City Central Hospital, Liaoyang, China.
Purpose: To investigate the safety and efficacy of endovascular embolization combined with external drainage for poor-grade ruptured cerebral aneurysms and risk factors.
Materials And Methods: Forty-six patients with poor-grade ruptured cerebral aneurysms treated with endovascular embolization combined with decompressive craniectomy and drainage were retrospectively enrolled.
Results: Coil embolization alone was performed in 29 (63.
Neurocrit Care
January 2025
Division of Neuroscience Critical Care, Departments of Neurology, Neurosurgery, and Anesthesiology and Critical Care Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
Background: Invasive mechanical ventilation can present complex challenges for patients with acute brain injury (ABI) in middle-income countries (MICs). We characterized the impact of country income level on weaning strategies and outcomes in patients with ABI.
Methods: A secondary analysis was performed on a registry of critically ill patients with ABI admitted to 73 intensive care units (ICUs) in 18 countries from 2018 to 2020.
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