Surgical management of traumatic parenchymal lesions

M. Ross Bullock, Randall Chesnut, Jamshid Ghajar, David Gordon, Roger Hartl, David W. Newell, Franco Servadei, Beverly C. Walters, Jack Wilberger

Research output: Contribution to journalReview article

96 Scopus citations

Abstract

The majority of studies regarding surgical treatment of parenchymal lesions are case series. Only one prospective clinical trial of treatment using surgical versus nonsurgical management has been published (61). The majority of evidence indicates that the development of parenchymal mass lesions, which are associated with progressive neurological dysfunction, medically refractory intracranial hypertension, or radiological signs of mass effect, are associated with a poor outcome if treated nonsurgically. Specific surgical criteria, however, have not been firmly established. Evidence also suggests that decompressive craniectomy may be the procedure of choice in patients with posttraumatic edema, hemispheric swelling, or diffuse injury, given the appropriate clinical context. This context has yet to be defined.

Original languageEnglish (US)
Pages (from-to)S225-S246
JournalNeurosurgery
Volume58
Issue numberSUPPL. 3
DOIs
StatePublished - Mar 1 2006

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Keywords

  • Coma
  • Computed tomographic parameters
  • Craniotomy
  • Decompressive craniectomy
  • Head injury
  • Herniation
  • Intracranial pressure monitoring
  • Parenchymal mass lesion
  • Surgical technique
  • Timing of surgery
  • Traumatic brain injury

ASJC Scopus subject areas

  • Clinical Neurology
  • Surgery

Cite this

Bullock, M. R., Chesnut, R., Ghajar, J., Gordon, D., Hartl, R., Newell, D. W., Servadei, F., Walters, B. C., & Wilberger, J. (2006). Surgical management of traumatic parenchymal lesions. Neurosurgery, 58(SUPPL. 3), S225-S246. https://doi.org/10.1227/01.NEU.0000210365.36914.E3