TY - JOUR
T1 - Do traumatic brain contusions increase in size after decompressive craniectomy?
AU - Sturiale, Carmelo Lucio
AU - De Bonis, Pasquale
AU - Rigante, Luigi
AU - Calandrelli, Rosalinda
AU - D'Arrigo, Sonia
AU - Pompucci, Angelo
AU - Mangiola, Annunziato
AU - D'Apolito, Gabriella
AU - Colosimo, Cesare
AU - Anile, Carmelo
PY - 2012
Y1 - 2012
N2 - Hemorrhagic contusions (HC) represent a common consequence of traumatic brain injury (TBI) and usually evolve during the first 12 hours 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. 25 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-cut off 50yo, 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 (≥ 2cc) 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 2-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.
AB - Hemorrhagic contusions (HC) represent a common consequence of traumatic brain injury (TBI) and usually evolve during the first 12 hours 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. 25 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-cut off 50yo, 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 (≥ 2cc) 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 2-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.
KW - brain contusion
KW - brain contusion
UR - http://hdl.handle.net/10807/31157
U2 - 10.1089/neu.2012.2556
DO - 10.1089/neu.2012.2556
M3 - Article
SN - 0897-7151
SP - N/A-N/A
JO - Journal of Neurotrauma
JF - Journal of Neurotrauma
ER -