Surgical Outcome of Brain Contusions Treated by Decompressive Craniotomy With or Without Lobectomy

Abstract

Objective:  To compare the surgical outcomes of decompressive craniotomy with or without lobectomy for patients presenting with brain contusions in a tertiary care trauma center.”

methods:  This randomized clinical trial was carried out in the Neurosurgery department, Allied Hospital, Faisalabad, for 1 year. Patients admitted with severe TBI were enrolled and underwent decompressive craniotomy (DC) with lax duraplasty, or decompressive craniotomy with lobectomy (DCWL) or contusionectomy and lax duraplasty

Results:  The mean GCS score at presentation in DC was 5.8±0.755 and in DCWL was 5.64±0.74. At the 3^rd month, 44% patients had GOS-E at vegetative state, 30% had GOS-E at lower severe disability, and 26% had GOS-E at upper severe disability in the DC group. But in the DCWL group, 2% patients had GOS-E at vegetative state, 22% were at lower severe disability 16% were at upper severe disability, 30% had GOS-E at upper moderate disability, and 30% were at lower moderate disability (P<0.05). At the 6^th month, 26% patients had GOS-E at dead state, 34% were at upper severe disability, and 40% were at lower moderate disability in the DC group. But in the DCWL group, 38% had GOS-E at upper moderate disability, 32% were at lower good recovery, and 30% were at upper good recovery (p<0.05).

Conclusion:  The surgical outcome of brain contusions treated by DCWL was better compared to DC without lobectomy.