The Repercussions of Decompressive Craniectomy in TBI Patients

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Aaron House

The Repercussions of Decompressive Craniectomy in People with Traumatic Brain Injuries

In a study published in the New England Journal of Medicine, an examination was performed to decide whether patients obtained a more favorable result using Decompressive Craniectomy as a method of treating severe traumatic brain injury versus using the standard method of care. Of patients who are hospitalized with severe traumatic brain injuries, over half either pass away or end up facing significant disabilities. It is reported that in the United States, the annual burden due to traumatic brain injuries amounts to more than $600 billion.

Following significant traumatic brain injuries, various therapies are given to reduce secondary injuries to the brain. One of the most common secondary injuries is increased intracranial pressure, which is often the result of cerebral edema. Many people with traumatic brain injuries end up experiencing increased intracranial pressure, which is resistant to many ordinary methods used to treat patients. In these situations, decompressive craniectomy is given with increasing frequency to control the intracranial pressure. The research in question involved a randomized, multicenter, controlled decompressive craniectomy in patients with traumatic brain injuries who had increased intracranial pressure and were under the age of 60.

Who Qualified for the Study

To qualify for the trial, patients must have been between the age of 15 and 59 and had severe, non-penetrating traumatic brain injuries. These injuries are defined with a score of 3 to 8 on the Glasgow Coma Scale. Excluded from the study were patients who were declared not suitable for active treatment by the medical teams caring for them, those who had various symptoms, including dilated and unreactive pupils, spinal cord injury, and those who had experienced cardiac arrest at the location where they were injured.

72 hours following the surgery, patients received a random assignment to either receive decompressive craniectomy and standard care or to only receive standard care. In those who were randomly chosen to receive decompressive craniectomy, the bone that was excised was stored at a precise temperature. Months later, the bone was replaced.

The Goal of the Trial

The trial was created to distinguish an increase in the number of favorable outcomes, which were defined as scores of 5 to 8 on the extended Glasgow Scale.

The Results of the Study

The results of the study reveal that people with severe diffuse traumatic brain injuries, as well as increased intracranial pressure resistant to regular types of treatment, have decreased intracranial pressure, decreased duration of ventilatory support, and less time spent in the intensive care unit. These patients, however, have a substantially worse outcome at six months, judged by the Extended Glasgow Outcome Scale, when compared to patients who only received standard treatment.

Speak with an Experienced Accident Attorney

If you or a loved one has incurred a traumatic brain injury, you should not hesitate to contact an experienced accident attorney. Contact House Law LLC today to schedule a free case evaluation. We are also prepared to meet with clients at a location convenient to them if their traumatic brain injury has left them unable to travel.

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