Effects of bilateral decompressive craniectomy on postoperative rehabilitation and NIHSS score in patients with bilateral frontal contusion complicated with central brain herniation

Abstract

Objective To investigate the effects of bilateral decompressive craniectomy on postoperative rehabilitation and degree of nerve function defect score in patients with bilateral frontal contusion complicated with central brain herniation. Methods Eighty-six patient with bilateral frontal contusion complicated with central brain herniation treated in Xinzhou People’s Hospital from February 2013 to February 2017 were selected and divided into control group and observation group according to treatment plans, with 43 cases in each group. Patients in observation group were treated by bilateral decompressive craniectomy, and patients in control group were treated by conventional conservative treatment. The duration of hospitalization and National Institute of Health stroke scale (NIHSS) score before and after treatment were compared between the two groups. Patients in the two groups were followed up for 6 months to compare the prognosis and quality of life score (SF-36) before treatment and 6 months after treatment. Results The duration of hospitalization in observation group was (16.51±5.37) d, which was shorter than that in control group [(29.67±7.23) d], and the difference was statistically significant (P<0.05). After treatment, the NIHSS scores of the two groups were lower than those before treatment, and the decrease in observation group was greater than that in control group, and the difference was statistically significant (P<0.05). The rank sum test showed that prognosis of observation group was better than that of control group, and the difference was statistically significant (P<0.05). At 6 months after treatment, the scores of SF-36 in the two groups were higher than those before treatment, and the increase in observation group was significantly greater than that in control group (P<0.05). Conclusions Performing bilateral decompressive craniectomy on patients with bilateral frontal contusion complicated with central brain herniation can obviously decrease the NIHSS score, reduce the injury of the nerve function, promote the postoperative rehabilitation, prognosis and quality of life. Key words: Bilateral frontal contusion complicated with central brain herniation; Bilateral decompressive craniectomy; National Institute of Health stroke score; Duration of hospitalization