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Remote Epidural Hemorrhage Following Unilateral Decompressive Hemicraniectomy in Head-Injured Patients.
MedLine Citation:
PMID:  23013227     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
Epidural hemorrhage (EDH) that develops remote to the decompressed hemisphere is a devastating morbidity after hemicraniectomy for traumatic brain injury (TBI). In this study, we aimed to investigate the incidence, risk factors, and outcome influence of postcraniectomy remote EDH. For this retrospective study, we enrolled 139 patients undergoing unilateral hemicraniectomy for TBI. The patients were subdivided into 2 groups based on whether EDH remote to the site of bone decompression was present (N = 11) or not (N = 128). We identified the intergroup differences in clinical parameters and outcomes. Multivariate odds regression was used to adjust for independent risk factors of the development of EDH. The incidence of remote EDH following decompressive hemicraniectomy for TBI was 7.9%. There were 2 independent risk factors for remote EDH, including absence of contusional hemorrhage (odds ratio, 95% confidence interval = 6.158, 1.090-34.802; p = 0.040) and presence of remote skull fracture (odds ratio, 95% confidence interval = 19.770, 2.194-178.152; p = 0.008) in preoperative computed tomography scans. The mean Glasgow Outcome Scale did not differ between the patients with or without EDH. In conclusion, remote EDH in patients undergoing unilateral decompressive hemicraniectomy for TBI is not uncommon. The absence of contusional hemorrhage and presence of remote skull fracture are independent risk factors. Although postcraniectomy remote EDH is devastating, timely computed tomography scanning and immediate hematoma evacuation are efficient and crucial for patient outcomes.
Authors:
Yu-Hua Huang; Tao-Chen Lee; Tsung-Han Lee; Ka-Yen Yang; Chen-Chieh Liao
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2012-9-26
Journal Detail:
Title:  Journal of neurotrauma     Volume:  -     ISSN:  1557-9042     ISO Abbreviation:  J. Neurotrauma     Publication Date:  2012 Sep 
Date Detail:
Created Date:  2012-9-27     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8811626     Medline TA:  J Neurotrauma     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Affiliation:
Kaohsiung Chang Gung Memorial Hospital, Neurosurgery, 123, Ta Pei Road, Niao Sung Hsiang, Kaohsiung Hsien, Taiwan, 833, +886-7-7317123 ext. 8011, +886-7-7354309; newlupin2001@yahoo.com.tw.
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