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首页> 外文期刊>The Canadian Journal of Neurological Sciences: le Journal Canadien des Sciences Neurologiques >Decompressive Craniectomy: Contra lateral Lesions and Metabolic Abnormalities
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Decompressive Craniectomy: Contra lateral Lesions and Metabolic Abnormalities

机译：减压颅骨切除术：对侧病变和代谢异常

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Objective: To define the incidence of new contralateral intracranial lesions following decompressive hemicraniectomy for blunt traumatic brain injury, and explore the potential association with metabolic factors that contribute to coagulopathy. Methods: We retrospectively reviewed the records and imaging of all patients treated with hemicraniectomy for blunt traumatic brain injury at our institution from May 2007 up to and including January 2012. Results: Twenty patients were identified during the time period to have undergone decompressive craniectomy for blunt head injury. The average age and Glasgow Coma Scale on presentation was 44.1 years (range: 19 72 years) and 6.5 (range: 3 - 14) respectively. All but one patient presented with an extra-axial hematoma as their surgical indication for craniectomy. Seven patients (35.0%) developed new contralateral lesions post-craniectomy. The average pen-operative pH, bicarbonate (HCO3) and hematocrit (HCT) levels for those with new contralateral lesions were lower than those without new lesions. Five of the seven patients (71.4%) with new lesions had abnormalities on their laboratory results that have been know to be attributable to coagulopathy, with four (57.1%) having two or more abnormal results. Eight of 13 (61.5%) patients without new lesion had laboratory abnormalites, with five (38.5%) having two or more abnormalities identified. Conclusions: The incidence of new contralateral lesions post-craniectomy for blunt head injury is 35.0% in our experience. There is an association between the metabolic derangements linked to trauma related coagulopathy and the formation of new lesions.
机译：目的：确定减压性半颅脑切除术对钝性颅脑损伤后新的对侧颅内病变的发生率，并探讨其与促凝因素的潜在关联。方法：我们回顾性回顾了从2007年5月至2012年1月（含）的所有接受半颅切除术治疗的钝性颅脑外伤患者的记录和影像学检查。结果：在此期间，确定了20例行了减压颅骨切除术的患者。头部受伤。呈现的平均年龄和格拉斯哥昏迷量表分别为44.1岁（范围：19 72岁）和6.5（范围：3-14）。除一名患者外，所有患者均出现了轴外血肿作为颅骨切除术的手术指征。七名患者（35.0％）在颅骨切除术后出现了新的对侧病变。有新的对侧病变的患者的平均术中pH，碳酸氢盐（HCO3）和血细胞比容（HCT）水平低于没有新病变的患者。七名新病变患者中有五名（71.4％）的实验室检查结果异常，可归因于凝血病，而四名（57.1％）则有两个或更多异常结果。 13例无新病灶的患者中有8例（61.5％）实验室异常，其中5例（38.5％）有两个或多个异常。结论：根据我们的经验，颅骨切除术后因钝性颅脑损伤而产生的新对侧病变的发生率为35.0％。与创伤相关性凝血病有关的代谢紊乱与新病变的形成之间存在关联。

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