The Management of Patients with Intradural Post-Traumatic Mass Lesions: A Multicenter Survey of Current Approaches to Surgical Management in 729 Patients Coordinated by the European Brain Injury Consortium

• DOI: 10.1227/01.neu.0000186239.10915.09
• Publication Date: 2005-12-05T10:13:35Z
• Authors: Christian Compagnone; Gordon D. Murray; Graham M. Teasdale; Andrew I.R. Maas; Domenico Esposito; Pietro Princi; Domenico D'Avella; Franco Servadei
• Keywords: Decompressive craniectomy; Coma (optics); Intracranial pressure monitoring

Abstract OBJECTIVE: Controversy exists about the indications and timing for surgery in head injured patients with an intradural mass lesion. The aim of this study was to survey contemporary approaches treatment lesion, placing a particular focus on utilization decompressive craniectomy. METHODS: A prospective international conducted over 3-month period 67 centers from 24 countries neurosurgical management lesion and/or radiological signs raised intracranial pressure. Information obtained demographic, clinical, features; surgical management, mortality at discharge. RESULTS: Over study, data were collected 729 consecutively admitted one participating centers. included 397 severe injury (Glasgow Coma Scale [GCS] 3–8), 155 moderate (GCS 9–12) 143 mild 13–15). An operation performed 502 (69%). Emergency (<24 h) most frequently extracerebral lesions (subdural hematomas) whereas delayed intracerebral hematoma or contusion. Decompressive craniectomy substantial number patients, either during emergency procedure (n = 134, 33%) 47, 31%). nearly always combined evacuation size decompression however considered too small 25% cases. CONCLUSION: results provide picture pressure some Neurosurgical Units across world. relative benefits early versus intraparenchymal indications, technique could be topics future research.