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Outcomes of decompressive craniectomy in adults with severe traumatic brain injury: the Groote Schuur Hospital experience
Includes bibliographical references.
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| Other Authors: | |
| Format: | Thesis |
| Language: | English |
| Published: |
Division of Neurosurgery
2015
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| _version_ | 1867613289742073856 |
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| access_status_str | Open Access |
| author | Enslin, Johannes Marthinus Nicolaas |
| author2 | Semple, P L |
| author_browse | Enslin, Johannes Marthinus Nicolaas Semple, P L |
| author_facet | Semple, P L Enslin, Johannes Marthinus Nicolaas |
| author_sort | Enslin, Johannes Marthinus Nicolaas |
| collection | Thesis |
| description | Includes bibliographical references. |
| format | Thesis |
| id | oai:open.uct.ac.za:11427/13110 |
| institution | University of Cape Town (South Africa) |
| language | eng |
| last_indexed | 2026-06-10T12:33:45.686Z |
| license_str | Not specified — see source repository |
| provenance_str_mv | Harvested via OAI-PMH from UCTD — University of Cape Town Open Access Repository |
| publishDate | 2015 |
| publishDateRange | 2015 |
| publishDateSort | 2015 |
| publisher | Division of Neurosurgery |
| publisherStr | Division of Neurosurgery |
| record_format | dspace |
| source_str | UCTD — University of Cape Town Open Access Repository |
| spelling | oai:open.uct.ac.za:11427/13110 Outcomes of decompressive craniectomy in adults with severe traumatic brain injury: the Groote Schuur Hospital experience Enslin, Johannes Marthinus Nicolaas Semple, P L Neurosurgery Includes bibliographical references. Object: The aim of this study was to assess outcome following decompressive craniectomy in adults with severe traumatic brain injury (TBI) in a South African neurosurgical unit. Methods: During a 78 month period (January 2005 – June 2011), 76 patients that underwent decompressive craniectomy for TBI in an attempt to lower raised intracranial pressure (ICP) were reviewed . All were older than 14 years and mass lesions were included. Thirty nine point four percent of the patients sustained blunt, low velocity injuries to the head and 19% were involved in motor vehicle accidents. Unilateral hemi-craniectomies were carried out in 81% of patients and 54 (75%) were done as primary decompressive craniectomies. Survivors were followed up for a period of at least six months and functional outcomes were measured using the Glasgow outcomes score. To simplify outcomes the patients were then dichotomised into outcome groups of good (GOS 4 and 5 ), and poor (GOS 1- 3). Results: At six months follow up 24 patients (33.3%) had a good outcome (GOS 4 or 5) and 48 patients (66.7%) had a poor outcome (GOS 1- 3). 32 patients (44.4%) died (GOS 1). There were 16 survivors in the poor group. Sixty percent o f survivors had a good outcome after decompressive craniectomy. Eighteen patients underwent secondary decompressive craniectomies and 54 (75%) primary decompressive craniectomies. Thirty - five percent of patients that underwent primary decompressive cranie ctomy had a good outcome, versus 38% in the secondary decompression group. Mortality was slightly higher in the primary decompression group (43%) than the secondary group (33%) . Factors that showed significant correlation with outcome were age, admission GCS and good response of ICP to decompressive craniectomy. Complications were encountered in 18% of patients with sepsis being the most common (11%). Conclusion: Decompressive craniectomy was associated with a functional outcome that was better than exp ected in patients with severe TBI and should still form part of salvage therapy in adults with TBI and elevated ICP. 2015-06-26T11:03:31Z 2015-06-26T11:03:31Z 2014 Master Thesis Masters MMed http://hdl.handle.net/11427/13110 eng application/pdf Division of Neurosurgery Faculty of Health Sciences University of Cape Town |
| spellingShingle | Neurosurgery Enslin, Johannes Marthinus Nicolaas Outcomes of decompressive craniectomy in adults with severe traumatic brain injury: the Groote Schuur Hospital experience |
| thesis_degree_str | Master's |
| title | Outcomes of decompressive craniectomy in adults with severe traumatic brain injury: the Groote Schuur Hospital experience |
| title_full | Outcomes of decompressive craniectomy in adults with severe traumatic brain injury: the Groote Schuur Hospital experience |
| title_fullStr | Outcomes of decompressive craniectomy in adults with severe traumatic brain injury: the Groote Schuur Hospital experience |
| title_full_unstemmed | Outcomes of decompressive craniectomy in adults with severe traumatic brain injury: the Groote Schuur Hospital experience |
| title_short | Outcomes of decompressive craniectomy in adults with severe traumatic brain injury: the Groote Schuur Hospital experience |
| title_sort | outcomes of decompressive craniectomy in adults with severe traumatic brain injury the groote schuur hospital experience |
| topic | Neurosurgery |
| url | http://hdl.handle.net/11427/13110 |
| work_keys_str_mv | AT enslinjohannesmarthinusnicolaas outcomesofdecompressivecraniectomyinadultswithseveretraumaticbraininjurythegrooteschuurhospitalexperience |