The treatment of the bilateral frontal brain contusion by the way of unilateral approach of cerebral falx incision

Abstract

Objective To investigate the development regularity of the bilateral frontal brain contusion,and its clinical features and treatment experience.The surgical methods of unilateral approach of cerebral falx incision was used to treat non-symmetry bilateral frontal brain contusion.Methods 120 patients with bilateral frontal brain contusion addimted from March 2004 to March 2008 were divided into two groups:a group of 60 cases of unilateral craniotomy;another group of 60 cases of conventional bilateral craniotomy,the were no significant difference between two groups about the the age ,sex and the time from injury to surgery (P＞0.05),all patients had preoperative and postoperative CT to confirmed intracranial changes.Results GOS in 6 month postinjury was used to judge the prognosis,there was no significant difference between two groups (P＞0.05).48 cases of good recovery,5 cases of residue,3 cases of severely disabled,2 cases of vegetative being,2 cases of dead in unilateral group .45 cases of good recovery,4 cases of residue,6 cases of severely disabled,2 cases of vegetative being,3 cases of dead in bilateral group.However,there was significant difference between the two groups when comparing with operative time,blood transfusion,hospital costs,length of stay in hospital,mental disorders and olfactory nerve injury (P＜0.01).Conclusion The use of unilateral approach of cerebral falx incision to remove bilateral frontal brain contusion and hematoma in the brain can significantly reduce the occurrence of delayed hematoma opportunities and the occurrence of cingulate gyrus hernia and central cerebral hernia.The operative indication should be strictly grasped. Key words: Craniocerebral trauma; Contusion and laceration of bilateral frontal lobe; Delayed intracranial hematoma; Surgical procedures,operative