Effect of bilateral decompressive craniectomy in the treatment of double frontal brain contusion complicated with central brain herniation

Abstract

Objective To investigate the effect of bilateral frontal decompressive craniectomy in the treatment of central herniation caused by bilateral frontal lobe contusion and laceration. Methods From July 2010 to December 2016, 65 patients with central herniation caused by bilateral frontal lobe contusion and laceration were treated with bilateral frontal decompression. The operative effect and prognosis were evaluated. Results The GOS prognostic score from 6 months to 1 year after operation was 4-5 in 20 cases, 3 in 17 cases, 2 in 13 cases and 1 in 15 cases, with a total of 30 cases having poor prognosis. Long-term follow-up (at least 3 years) of 30 patients with GOS score of 2-3 showed that GOS had little improvement in 3 years after operation. Conclusion Bilateral frontal lobe contusion and laceration develops rapidly, which can easily lead to central herniation. Decompression of bilateral frontal bone flap is an effective method for the treatment of central herniation. Key words: Bilateral frontal lobe contusion; Central herniation; Bilateral decompressive craniectomy