Objective: Traumatic brain injury (TBI) is the leading cause of morbidity and mortality mainly in young people, and also one of the most common neurosurgical diseases in daily practice. The surgical management is a fundamental part of TBI. The aim of this study is to present the results in 76 patients operated on at Almenara Hospital in 2008 and 2009.
Patients and Methods: We conducted a descriptive study of patients undergoing BTI during 2008 and 2009. We reviewed the medical records and operative reports, and pooled data on sex, age, disease duration, degree of BTI, location, type of medical management and use of ICP, type of surgery, hospital stay, GOS and Glasgow discharge, complications and mortality.
Results: 76 patients were operated of which 76% were male and 24% female. The most affected age group was 20-29 years (18.4%) followed by the under-10 years (15.8%). Patients admitted to hospital more frequently (38.3%) among 13-24, with moderate TBI most common grade (63.3%). Regarding treatment, the hypertonic solution was the most used in the ICP management, using intracranial pressure monitoring in 15.8% of cases. The patients were operated on by craniotomy (78.9%) and decompressive craniectomy (21.1%). The average Glasgow Coma Scale at admission increased from 10.9 to 14 at discharge, being higher in the EH and lower in contusion. The most common discharge GOS was V (36.8%) and IV (35.6%). The most common complication was pneumonia (27.6%) and overall mortality rate was 11.8% being higher (21%) in the ASDH.
Conclusions: The BTI treatment has evolved in recent years, the use of hypertonic solutions and intracranial pressure monitoring are essential in the medical management of moderate and severe TBI, the classic craniotomy is the cornerstone of surgical management but decompressive craniectomy being increasingly especially common in cerebral contusion. Medical and surgical optimal treatment are essential to achieving shorter hospital stay, good Glasgow scale and GOS, reduce complications and mortality rate.