• Domenico Intiso, Teresa Lombardi, Giuseppina Grimaldi, Andrea Iarossi, Maurizio Tolfa, Mario Russo, and Filomena Di Rienzo.
• Neuro-rehabilitation Unit, Scientific Institute Casa Sollievo della Sofferenza, Viale dei Cappuccini 1, San Giovanni Rotondo (FG), Italy. d.intiso@operapadrepio.it
• Brain Inj. 2011 Jan 1;25(4):379-86.

ObjectiveDecompressive craniectomy (DC) in severe traumatic brain injury (TBI) remains a controversial therapeutic strategy. The long-term functional recovery and health status in a sample of decompressive craniectomized TBI are reported.MethodsPatients with TBI who underwent DC were retrospectively investigated. Patients with cerebral haemorrhage (CH) and DC were considered as control group. In all survival patients admitted to a neuro-rehabilitation setting, the modified Rankin (mRS), Glasgow Outcome scale (GOS) and Barthel Scales (BS) were administered at admission, discharge, 1 year and follow-up. The quality-of-life was evaluated with the SF-36 questionnaire at follow-up (41.1±16.6 months).ResultsSeventy (33 F, 37 M, mean age=46.8, SD=18.8) patients were enrolled: 46 (20 F, 26 M) subjects with TBI and 24 (13 F, 11 M) with CH. After surgery, 11 (23.9%) and 10 (41.6%) subjects in the TBI and CH group, respectively, died. The mean Barthel scores were 4.0 (SD=5.9), 60.9 (SD=37.5), 63.7 (SD=35.1) and 67.3 (SD=38.2) (p<0.001) and median GOS was 3, 4, 4 and 4 at admission, discharge, 1 year and follow-up, respectively, in TBI patients. Seventeen (36.9%) patients with TBI and four (16.6%) with CH made a full recovery. The SF-36 questionnaire showed significant abnormalities in all domains of health status in both groups.ConclusionCraniectomized patients with TBI achieved good long-term outcome, although they experienced significant difficulties in health status.

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