A brain CT scan showed bilateral fronto-temporal fracture, diffuse brain hematoma contusion, traumatic subarachnoid hemorrhage, right extradural hematoma and bilateral fronto-temporo-parietal acute SDH that was more pronounced on the right side.ĭiscussion and conclusion: Follow-up after the operations showed an extended Glasgow outcome scale (EGOS) score of 8 and a very good functional recovery for both patients. The second presented with severe TBI following an automobile accident, with a GCS score of 4 and iso-reactive pupils. A brain CT scan showed right frontal fracture, bifrontal hematoma contusion, a fronto-temporo-parietal acute subdural hematoma (SDH) with a thickness of 14 mm on the right side, traumatic subarachnoid hemorrhage, with 20 mm of midline shift to the left side, and diffuse brain edema. The first suffered severe TBI following an aggression, with a GCS score of 3 and bilaterally dilated unreactive pupils. Decompressive craniectomy has been avoided in such patients owing to poor outcomes and poor functional recoveries in previous cases of treatment using this method.Ĭlinical presentation: Two patients are presented in our case series. However, few studies have followed patients with TBI who have a Glasgow coma scale (GCS) score of 3 or 4 (out of 15). Received: 24 September, 2018 Accepted: 04 December, 2018 Published: 17 May, 2019īackground: Decompressive craniectomy is a surgical management option for severe traumatic brain injury (TBI). J Clinical Case Rep Case Stud 2018: 11-15. * Corresponding author: Afif AFIF, Department of Neurosurgery, Department of Anatomy, INSERM U 1028, Pain center, Pierre Wertheimer Hos-pital, Hospices Civils de Lyon, Lyon 1 University, E-mail: Afif AFIF (2018) Decompressive Craniectomy Following Severe Traumatic Brain Injury with an Initial Glasgow Coma Scale Score of 3 or 4. Decompressive Craniectomy Following Severe Traumatic Brain Injury with an Initial Glasgow Coma Scale Score of 3 or 4ĭepartment of Neurosurgery, Department of Anatomy, INSERM U 1028, Pain center, Pierre Wertheimer Hospital, Hospices Civils de Lyon, Lyon 1 University
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