Bilateral craniotomies for blunt head trauma

Nizam Razack, Ran Vijai Pratap Singh, David Petrin, Philip Villanueva, Barth A Green

Research output: Contribution to journalArticle

6 Citations (Scopus)

Abstract

Development of delayed or recurrent intracranial hematomas requiring reexploration or a secondary craniotomy is well known. Patients with bilateral pathology requiring bilateral craniotomies as the initial emergency operative intervention, however, are uncommon. The lack of available literature and the large volume of head trauma seen at our institution prompted us to analyze the retrospective data on blunt head injury requiring bilateral craniotomies. Twenty patients underwent bilateral craniotomies at the University of Miami/Jackson Memorial Medical Center between January 1986 and June 1994. Ages ranged from 18 to 85 years. Mechanism of injury included motor vehicle crash (n = 4), pedestrian hit by automobile (n = 4), assault (n = 8), fall from height (n = 3), and unknown (n = 1). Epidural hematomas, acute subdural hematomas, contusions, and intracerebral hematomas were seen in varying combinations. The preoperative Glasgow Coma Scale (GCS) score ranged from 4 to 14, with a mean of 8.8 (±0.82 SE). Sixteen of the 20 patients survived and were discharged from the hospital. The survivors' Rancho Los Amigos Scale score on discharge ranged from 2 to 8, with a mean of 6.1 (±0.45 SE). A Fisher's exact test was performed to compare the outcome between the patients with mild (GCS score 13-15) to moderate (GCS score 9- 12) head injury and those with severe (GCS score 4-8) head injury. It showed a statistically higher frequency of death in the severe category (p < 0.05). In conclusion, the outcome of patients with bilateral pathology requiring emergency bilateral craniotomy at initial treatment correlated well with their GCS scores at initial presentation.

Original languageEnglish
Pages (from-to)840-843
Number of pages4
JournalJournal of Trauma - Injury, Infection and Critical Care
Volume43
Issue number5
StatePublished - Nov 1 1997

Fingerprint

Glasgow Coma Scale
Craniotomy
Craniocerebral Trauma
Hematoma
Emergencies
Hematoma, Subdural, Acute
Pathology
Closed Head Injuries
Automobiles
Contusions
Motor Vehicles
Survivors
Wounds and Injuries

ASJC Scopus subject areas

  • Surgery

Cite this

Razack, N., Singh, R. V. P., Petrin, D., Villanueva, P., & Green, B. A. (1997). Bilateral craniotomies for blunt head trauma. Journal of Trauma - Injury, Infection and Critical Care, 43(5), 840-843.

Bilateral craniotomies for blunt head trauma. / Razack, Nizam; Singh, Ran Vijai Pratap; Petrin, David; Villanueva, Philip; Green, Barth A.

In: Journal of Trauma - Injury, Infection and Critical Care, Vol. 43, No. 5, 01.11.1997, p. 840-843.

Research output: Contribution to journalArticle

Razack, N, Singh, RVP, Petrin, D, Villanueva, P & Green, BA 1997, 'Bilateral craniotomies for blunt head trauma', Journal of Trauma - Injury, Infection and Critical Care, vol. 43, no. 5, pp. 840-843.
Razack N, Singh RVP, Petrin D, Villanueva P, Green BA. Bilateral craniotomies for blunt head trauma. Journal of Trauma - Injury, Infection and Critical Care. 1997 Nov 1;43(5):840-843.
Razack, Nizam ; Singh, Ran Vijai Pratap ; Petrin, David ; Villanueva, Philip ; Green, Barth A. / Bilateral craniotomies for blunt head trauma. In: Journal of Trauma - Injury, Infection and Critical Care. 1997 ; Vol. 43, No. 5. pp. 840-843.
@article{2f06492ec9fe4362bca13829063a0a1a,
title = "Bilateral craniotomies for blunt head trauma",
abstract = "Development of delayed or recurrent intracranial hematomas requiring reexploration or a secondary craniotomy is well known. Patients with bilateral pathology requiring bilateral craniotomies as the initial emergency operative intervention, however, are uncommon. The lack of available literature and the large volume of head trauma seen at our institution prompted us to analyze the retrospective data on blunt head injury requiring bilateral craniotomies. Twenty patients underwent bilateral craniotomies at the University of Miami/Jackson Memorial Medical Center between January 1986 and June 1994. Ages ranged from 18 to 85 years. Mechanism of injury included motor vehicle crash (n = 4), pedestrian hit by automobile (n = 4), assault (n = 8), fall from height (n = 3), and unknown (n = 1). Epidural hematomas, acute subdural hematomas, contusions, and intracerebral hematomas were seen in varying combinations. The preoperative Glasgow Coma Scale (GCS) score ranged from 4 to 14, with a mean of 8.8 (±0.82 SE). Sixteen of the 20 patients survived and were discharged from the hospital. The survivors' Rancho Los Amigos Scale score on discharge ranged from 2 to 8, with a mean of 6.1 (±0.45 SE). A Fisher's exact test was performed to compare the outcome between the patients with mild (GCS score 13-15) to moderate (GCS score 9- 12) head injury and those with severe (GCS score 4-8) head injury. It showed a statistically higher frequency of death in the severe category (p < 0.05). In conclusion, the outcome of patients with bilateral pathology requiring emergency bilateral craniotomy at initial treatment correlated well with their GCS scores at initial presentation.",
author = "Nizam Razack and Singh, {Ran Vijai Pratap} and David Petrin and Philip Villanueva and Green, {Barth A}",
year = "1997",
month = "11",
day = "1",
language = "English",
volume = "43",
pages = "840--843",
journal = "Journal of Trauma and Acute Care Surgery",
issn = "2163-0755",
publisher = "Lippincott Williams and Wilkins",
number = "5",

}

TY - JOUR

T1 - Bilateral craniotomies for blunt head trauma

AU - Razack, Nizam

AU - Singh, Ran Vijai Pratap

AU - Petrin, David

AU - Villanueva, Philip

AU - Green, Barth A

PY - 1997/11/1

Y1 - 1997/11/1

N2 - Development of delayed or recurrent intracranial hematomas requiring reexploration or a secondary craniotomy is well known. Patients with bilateral pathology requiring bilateral craniotomies as the initial emergency operative intervention, however, are uncommon. The lack of available literature and the large volume of head trauma seen at our institution prompted us to analyze the retrospective data on blunt head injury requiring bilateral craniotomies. Twenty patients underwent bilateral craniotomies at the University of Miami/Jackson Memorial Medical Center between January 1986 and June 1994. Ages ranged from 18 to 85 years. Mechanism of injury included motor vehicle crash (n = 4), pedestrian hit by automobile (n = 4), assault (n = 8), fall from height (n = 3), and unknown (n = 1). Epidural hematomas, acute subdural hematomas, contusions, and intracerebral hematomas were seen in varying combinations. The preoperative Glasgow Coma Scale (GCS) score ranged from 4 to 14, with a mean of 8.8 (±0.82 SE). Sixteen of the 20 patients survived and were discharged from the hospital. The survivors' Rancho Los Amigos Scale score on discharge ranged from 2 to 8, with a mean of 6.1 (±0.45 SE). A Fisher's exact test was performed to compare the outcome between the patients with mild (GCS score 13-15) to moderate (GCS score 9- 12) head injury and those with severe (GCS score 4-8) head injury. It showed a statistically higher frequency of death in the severe category (p < 0.05). In conclusion, the outcome of patients with bilateral pathology requiring emergency bilateral craniotomy at initial treatment correlated well with their GCS scores at initial presentation.

AB - Development of delayed or recurrent intracranial hematomas requiring reexploration or a secondary craniotomy is well known. Patients with bilateral pathology requiring bilateral craniotomies as the initial emergency operative intervention, however, are uncommon. The lack of available literature and the large volume of head trauma seen at our institution prompted us to analyze the retrospective data on blunt head injury requiring bilateral craniotomies. Twenty patients underwent bilateral craniotomies at the University of Miami/Jackson Memorial Medical Center between January 1986 and June 1994. Ages ranged from 18 to 85 years. Mechanism of injury included motor vehicle crash (n = 4), pedestrian hit by automobile (n = 4), assault (n = 8), fall from height (n = 3), and unknown (n = 1). Epidural hematomas, acute subdural hematomas, contusions, and intracerebral hematomas were seen in varying combinations. The preoperative Glasgow Coma Scale (GCS) score ranged from 4 to 14, with a mean of 8.8 (±0.82 SE). Sixteen of the 20 patients survived and were discharged from the hospital. The survivors' Rancho Los Amigos Scale score on discharge ranged from 2 to 8, with a mean of 6.1 (±0.45 SE). A Fisher's exact test was performed to compare the outcome between the patients with mild (GCS score 13-15) to moderate (GCS score 9- 12) head injury and those with severe (GCS score 4-8) head injury. It showed a statistically higher frequency of death in the severe category (p < 0.05). In conclusion, the outcome of patients with bilateral pathology requiring emergency bilateral craniotomy at initial treatment correlated well with their GCS scores at initial presentation.

UR - http://www.scopus.com/inward/record.url?scp=0030730864&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=0030730864&partnerID=8YFLogxK

M3 - Article

C2 - 9390498

AN - SCOPUS:0030730864

VL - 43

SP - 840

EP - 843

JO - Journal of Trauma and Acute Care Surgery

JF - Journal of Trauma and Acute Care Surgery

SN - 2163-0755

IS - 5

ER -