• Neurological research · Jul 2013

    Case Reports

    Uncorrected traumatic coagulopathy is associated with severe brain swelling during decompressive surgery to evacuate a supratentorial intradural mass lesion in patients with traumatic brain injury.

    • Ke Wang, Yajun Xue, Xianzhen Chen, Bin Zhou, and Meiqing Lou.
    • Department of Neurosurgery, Shanghai Tenth People's Hospital, Tongji University, China. trizzt@gmail.com
    • Neurol. Res. 2013 Jul 1; 35 (6): 642-8.

    ObjectiveThis study investigated the relationship between traumatic coagulopathy and severe brain swelling (SBS) during decompressive surgery to evacuate a supratentorial intradural mass lesion in patients with traumatic brain injury (TBI).MethodsA retrospective study was conducted in 96 patients who consecutively suffered from isolated TBI and underwent decompressive surgery to evacuate a supratentorial traumatic mass lesion by unilateral craniotomy. Their medical history, radiographic information, and surgical notes were reviewed. The relationship between traumatic coagulopathy and intraoperative SBS was evaluated.ResultsFifty-six patients presented with traumatic coagulopathy according to their preoperative coagulation panels. Thirty of them had the disorder corrected before surgery while the remaining patients did not. Twenty-four patients developed intraoperative SBS, and 22 (91.7%) of them were related to new or progressive formation of distal intracranial lesions during the surgery. Patients with uncorrected coagulopathy demonstrated a significantly higher risk of intraoperative SBS than those with corrected and no coagulopathy (61.5% vs 11.4%, P < 0.001). There was no significant difference in the incidence of intraoperative SBS between patients with corrected and no coagulopathy (13.3% versus 10.0%, P > 0.05). Multivariate logistic regression analysis showed that uncorrected coagulopathy was an independent risk factor and related to an 11.5-fold increased risk of intraoperative SBS.ConclusionsIntraoperative SBS is not a rare event during decompressive surgery to evacuate a supratentorial intradural mass lesion in patients with TBI. Such surgery should be cautiously considered and performed given the existence of uncorrected traumatic coagulopathy, which is associated with an increased risk of intraoperative SBS.

      Pubmed     Full text   Copy Citation     Plaintext  

      Add institutional full text...

    Notes

     
    Knowledge, pearl, summary or comment to share?
    300 characters remaining
    help        
    You can also include formatting, links, images and footnotes in your notes
    • Simple formatting can be added to notes, such as *italics*, _underline_ or **bold**.
    • Superscript can be denoted by <sup>text</sup> and subscript <sub>text</sub>.
    • Numbered or bulleted lists can be created using either numbered lines 1. 2. 3., hyphens - or asterisks *.
    • Links can be included with: [my link to pubmed](http://pubmed.com)
    • Images can be included with: ![alt text](https://bestmedicaljournal.com/study_graph.jpg "Image Title Text")
    • For footnotes use [^1](This is a footnote.) inline.
    • Or use an inline reference [^1] to refer to a longer footnote elseweher in the document [^1]: This is a long footnote..

    hide…

What will the 'Medical Journal of You' look like?

Start your free 21 day trial now.

We guarantee your privacy. Your email address will not be shared.