H shaped incision in the application of hemicraniectomy Experience.docVIP

 PAGE \* MERGEFORMAT 8 H shaped incision in the application of hemicraniectomy Experience [Keywords:] frontotemporal hemicraniectomy with severe head injury “h” shaped incision Acute severe brain injury in the clinical treatment of patients, most require surgery, the complexity of the mechanism of injury, often with multiple locations and multiple types of severe brain contusion, brain edema and hematoma exists. Which, for the unilateral frontotemporal injury, surgery fully exposed, remove the hematoma and necrotic brain tissue for effective treatment of decompression is a prerequisite for success. this group from October 1999 to December 2007 33 patients were treated between such patients “h “shaped incision approach [1] hemicraniectomy [2] treatment, satisfactory results are reported as follows. Materials and Methods 1. General Information 21 males and 12 females, aged from 15 to 72 years, mean 43.3 years old. The causes of injury: 19 cases of traffic accidents, fall injuries in 8 cases, 2 cases of combat injuries, other causes in 4 cases. Focus areas: the occipital in 18 cases, frontotemporal in 10 cases, unknown in 5 cases. from injury to admission time: 0.5 ~ 21 h, an average of 7.2 h. Clinical manifestations: GSC score 3 to 5 minutes in 21 cases, 6 to 8 minutes and 12 cases. moderate coma in 11 cases, 22 cases of severe coma. unilateral mydriasis in 10 cases, 23 cases of bilateral mydriasis. CT examinations showed: unilateral frontotemporal / brain contusion frontotemporal the top and / or epidural (hematoma exists, hematoma volume of 35 ~ 120 ml range, pool and saddle ring significantly reduced the pool of 18 patients, disappeared in 15 cases. 2. Surgical methods All cases the selective application of “h” shaped incision line hemicraniectomy (see Figure 1: scalp incision: the first began to make the first incision on the edge of the midpoint of the zygomatic arch, across the sagittal line 2 ~ 3 cm, confined to the opposite edge