Document Detail

Severe head injury management in a general surgical department.
MedLine Citation:
PMID:  8048888     Owner:  NLM     Status:  MEDLINE    
Sixty-nine severely head-injured patients treated by general surgeons over a 28 month period with admission Glasgow Coma Scale motor scores of 3 to 8 were reviewed retrospectively. Fifty-one patients were comatose on admission with periods from injury to admission exceeding 4 h in 34 patients who were referred from peripheral hospitals. Forty patients with acute intracranial bleeding underwent emergency decompressive surgery with 13 good recoveries and 18 deaths; good recoveries were observed in 11 of 20 patients with extradural haemorrhages, one out of eight patients with subdural haemorrhages, and one of 12 patients with intracerebral and/or combined haemorrhages. Twenty-nine patients with no evidence of acute mass lesions were treated medically with sedation, mechanical ventilation and mannitol infusion for cerebral decompression with seven good recoveries and 16 deaths. There were 15 good outcomes in 40 patients with admission motor scores of 6, 7 or 8 and five good outcomes in 29 patients with scores of 3, 4 or 5. A good outcome of 29% in the study may be improved by (i) better neurosurgical training of surgical and nursing staff; (ii) provision of technologically advanced diagnostic and treatment modalities; (iii) an efficient referral system; and (iv) provision of effective long-term rehabilitation.
R Visvanathan
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  The Australian and New Zealand journal of surgery     Volume:  64     ISSN:  0004-8682     ISO Abbreviation:  Aust N Z J Surg     Publication Date:  1994 Aug 
Date Detail:
Created Date:  1994-08-30     Completed Date:  1994-08-30     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  0373115     Medline TA:  Aust N Z J Surg     Country:  AUSTRALIA    
Other Details:
Languages:  eng     Pagination:  527-9     Citation Subset:  IM    
Department of Surgery, University Hospital (USM), Kota Bharu, Kelantan, Malaysia.
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MeSH Terms
Activities of Daily Living
Brain Edema / prevention & control
Brain Injuries / radiography,  surgery*
Cerebral Hemorrhage / surgery
Coma / radiography,  surgery
Craniocerebral Trauma / radiography,  surgery*
Glasgow Coma Scale
Neurologic Examination
Retrospective Studies
Surgery Department, Hospital
Survival Rate
Time Factors
Tomography, X-Ray Computed
Treatment Outcome
Comment In:
Aust N Z J Surg. 1994 Aug;64(8):525-6   [PMID:  8048887 ]

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