Objective: To summarize the peri-operative experience from 53patients with traumatic head injuries with GCS score 3-5.Methods: Fifty-three most severely head-injured patients with GCS score 3-5 were admitted to our department and treated operatively from Oct. 1994 to Jun. 1998 and the data were analyzed retrospectively. Results: Thirty-seven cases (69.8%) survived, among them 28 (52.8%) had a good recovery or moderate disability, and 9 (17%) had severe deficits. The other 16 (30.2%) died after therapy.Conclusions: The prognosis of most severely head-injured patients could be improved by peri-operative treatment including premedical care, early evacuation of intracranial hematoma with large decompressive craniectomies, intracranial hypertension monitoring, moderate hypothermia therapy, effective prevention and treatment of cerebral vasospasm and complications.
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