Early Decompressive Craniectomy: A Life Saving Option in Closed Head Trauma

Abstract

Aim: To determine outcome and factors associated with outcome among patients with closed head injury who underwent decompressive craniectomy. Methodology: Cross sectional analytical study conducted in Neurosurgery Department of teaching hospital Dera Ghazi Khan from January, 2021 to June, 2021. Total 105 patients fulfilling the inclusion criteria were enrolled in the study. Approval of ethical review committee was obtained. All the patients with closed head injury which underwent decompressive craniectomy were included. Socio demographic profile, mode of injury, Glasgow Coma Scale (GCS) at admission time, pupillary reaction and timing from hospital admission to surgery, duration of surgery, length of hospital stay and occurrence of CSF leakage was noted. SPSS version 22 was used for data entry and analysis. Results: Head injury was more common in males. 43.8% cases admitted with GCS score between 3-8 and with head injury by road traffic accident. Leakage of CSF was recorded in 13.3% patients. Mortality was recorded in 18.1% patients. GCS at time of admission, time elapsed between admission and surgery and duration of surgery was significantly associated with the outcome. Conclusion: Early decompressive craniectomy significantly reduce death rate in patients with closed head injury. Keywords: Craniectomy, Outcome, Glasgow coma scale