The basal cisternostomy for management of severe traumatic brain injury: A retrospective study
Purpose: Traumatic brain injury (TBI) is a significant public health issue that impacts individuals all over the world and is one of the main causes of mortality and morbidity. Decompressive craniectomy is the usual course of treatment. Basal cisternostomy has been shown to be highly effective as an...
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| Format: | Article |
| Language: | English |
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Elsevier
2025-03-01
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| Series: | Chinese Journal of Traumatology |
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| Online Access: | http://www.sciencedirect.com/science/article/pii/S1008127524001561 |
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| author | Tangrui Han Zhiqiang Jia Xiaokai Zhang Hao Wu Qiang Li Shiqi Cheng Yan Zhang Yonghong Wang |
| author_facet | Tangrui Han Zhiqiang Jia Xiaokai Zhang Hao Wu Qiang Li Shiqi Cheng Yan Zhang Yonghong Wang |
| author_sort | Tangrui Han |
| collection | DOAJ |
| description | Purpose: Traumatic brain injury (TBI) is a significant public health issue that impacts individuals all over the world and is one of the main causes of mortality and morbidity. Decompressive craniectomy is the usual course of treatment. Basal cisternostomy has been shown to be highly effective as an alternative procedure to decompressive craniectomy. Methods: We conducted a retrospective cohort of patients who received surgery for severe TBI between January 2019 and March 2023. Inclusion criterias were patients between the ages of 18 and 70 years who met the diagnostic criteria for severe TBI at first presentation and who underwent surgical intervention. The exclusion criteria were patients who have severe multiple injuries at the time of admission; preoperative intracranial pressure > 60 mmHg; cognitive impairment before the onset of the disease; hematologic disorders; or impaired functioning of the heart, liver, kidneys, or other visceral organs. Depending on the surgical approach, the patients were categorized into decompressive craniectomy group as well as basal cisternostomy group. General data and postoperative indicators, including Glasgow coma scale, intracranial pressure, etc., were recorded for both groups of patients. Among them, the Glasgow outcome scale extended assessment at 6 months served as the primary outcome. After that, the data were statistically analyzed using SPSS software. Results: The trial enrolled 41 patients (32 men and 9 women) who met the inclusion criteria. Among them, 25 patients received decompressive decompressive craniectomy, and 16 patients received basal cisternostomy. Three days postoperative intracranial pressure levels were 10.07 ± 2.94 mmHg and 17.15 ± 14.65 mmHg (p = 0.013), respectively. The 6 months following discharge Glasgow outcome scale extended of patients was 4.73 ± 2.28 and 3.14 ± 2.15 (p = 0.027), respectively. Conclusion: Our study reveals that basal cisternostomy in patients with surgically treated severe TBI has demonstrated significant efficacy in reducing intracranial pressure as well as patient prognosis follow-up and avoids removal of the bone flap. The efficacy of cisternostomy has to be studied in larger, multi-clinical center randomized trials. |
| format | Article |
| id | doaj-art-53851377cfdc4fd1b4afe8d4071f62d2 |
| institution | Kabale University |
| issn | 1008-1275 |
| language | English |
| publishDate | 2025-03-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Chinese Journal of Traumatology |
| spelling | doaj-art-53851377cfdc4fd1b4afe8d4071f62d22025-08-20T03:42:53ZengElsevierChinese Journal of Traumatology1008-12752025-03-0128211812310.1016/j.cjtee.2024.09.007The basal cisternostomy for management of severe traumatic brain injury: A retrospective studyTangrui Han0Zhiqiang Jia1Xiaokai Zhang2Hao Wu3Qiang Li4Shiqi Cheng5Yan Zhang6Yonghong Wang7Third Hospital of Shanxi Medical University, Shanxi Bethune Hospital, Shanxi Academy of Medical Sciences, Tongji Shanxi Hospital, Taiyuan, 030032, ChinaDepartment of Neurosurgery, First Hospital of Shanxi Medical University, Taiyuan, 030001, ChinaThird Hospital of Shanxi Medical University, Shanxi Bethune Hospital, Shanxi Academy of Medical Sciences, Tongji Shanxi Hospital, Taiyuan, 030032, ChinaDepartment of Neurosurgery, Shanxi Bethune Hospital, Shanxi Academy of Medical Sciences, Tongji Shanxi Hospital, Third Hospital of Shanxi Medical University, Taiyuan, 030032, ChinaDepartment of Neurosurgery, Shanxi Bethune Hospital, Shanxi Academy of Medical Sciences, Tongji Shanxi Hospital, Third Hospital of Shanxi Medical University, Taiyuan, 030032, ChinaDepartment of Neurosurgery, The Second Affiliated Hospital of Nanchang University, Nanchang, 330009, ChinaDepartment of Neurosurgery, The Second Affiliated Hospital of Nanchang University, Nanchang, 330009, ChinaDepartment of Neurosurgery, Shanxi Bethune Hospital, Shanxi Academy of Medical Sciences, Tongji Shanxi Hospital, Third Hospital of Shanxi Medical University, Taiyuan, 030032, China; Corresponding author.Purpose: Traumatic brain injury (TBI) is a significant public health issue that impacts individuals all over the world and is one of the main causes of mortality and morbidity. Decompressive craniectomy is the usual course of treatment. Basal cisternostomy has been shown to be highly effective as an alternative procedure to decompressive craniectomy. Methods: We conducted a retrospective cohort of patients who received surgery for severe TBI between January 2019 and March 2023. Inclusion criterias were patients between the ages of 18 and 70 years who met the diagnostic criteria for severe TBI at first presentation and who underwent surgical intervention. The exclusion criteria were patients who have severe multiple injuries at the time of admission; preoperative intracranial pressure > 60 mmHg; cognitive impairment before the onset of the disease; hematologic disorders; or impaired functioning of the heart, liver, kidneys, or other visceral organs. Depending on the surgical approach, the patients were categorized into decompressive craniectomy group as well as basal cisternostomy group. General data and postoperative indicators, including Glasgow coma scale, intracranial pressure, etc., were recorded for both groups of patients. Among them, the Glasgow outcome scale extended assessment at 6 months served as the primary outcome. After that, the data were statistically analyzed using SPSS software. Results: The trial enrolled 41 patients (32 men and 9 women) who met the inclusion criteria. Among them, 25 patients received decompressive decompressive craniectomy, and 16 patients received basal cisternostomy. Three days postoperative intracranial pressure levels were 10.07 ± 2.94 mmHg and 17.15 ± 14.65 mmHg (p = 0.013), respectively. The 6 months following discharge Glasgow outcome scale extended of patients was 4.73 ± 2.28 and 3.14 ± 2.15 (p = 0.027), respectively. Conclusion: Our study reveals that basal cisternostomy in patients with surgically treated severe TBI has demonstrated significant efficacy in reducing intracranial pressure as well as patient prognosis follow-up and avoids removal of the bone flap. The efficacy of cisternostomy has to be studied in larger, multi-clinical center randomized trials.http://www.sciencedirect.com/science/article/pii/S1008127524001561Basal cisternostomyCerebrospinal fluidDecompressive craniectomyGlymphatic systemIntracranial pressureTraumatic brain injury |
| spellingShingle | Tangrui Han Zhiqiang Jia Xiaokai Zhang Hao Wu Qiang Li Shiqi Cheng Yan Zhang Yonghong Wang The basal cisternostomy for management of severe traumatic brain injury: A retrospective study Chinese Journal of Traumatology Basal cisternostomy Cerebrospinal fluid Decompressive craniectomy Glymphatic system Intracranial pressure Traumatic brain injury |
| title | The basal cisternostomy for management of severe traumatic brain injury: A retrospective study |
| title_full | The basal cisternostomy for management of severe traumatic brain injury: A retrospective study |
| title_fullStr | The basal cisternostomy for management of severe traumatic brain injury: A retrospective study |
| title_full_unstemmed | The basal cisternostomy for management of severe traumatic brain injury: A retrospective study |
| title_short | The basal cisternostomy for management of severe traumatic brain injury: A retrospective study |
| title_sort | basal cisternostomy for management of severe traumatic brain injury a retrospective study |
| topic | Basal cisternostomy Cerebrospinal fluid Decompressive craniectomy Glymphatic system Intracranial pressure Traumatic brain injury |
| url | http://www.sciencedirect.com/science/article/pii/S1008127524001561 |
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