ABSTRACT
Objective: The present study was designed to discuss the practicability and value of stepwise small dural window and Paine's point puncture mediated external intraventricular drainage (EID) for craniectomy in patients with severe brain injury compared with standard trauma craniectomy．
Methods: Ninetypatients with an Glasgow Coma Scale score less than 8 or less were randomly divided into two groups: standard trauma craniectomy group (44 patients, control group) and stepwise small dural window and Paine 's point puncture mediated EID group (46 patients, improved group) and the clinical data were compared．
Results: The improved group had no statistically significance with control group on duration of surgery and the incidence of intracranial infection (p=0.732, 0.774). However, the improved group had statistically significance with control group on the incidence of intraoperative encephalocele, postoperative delayed hematoma, postoperative epilepsy and hydrocephalus in need of extra surgery (P=0.007、0.020、0.014、0.011). Glasgow outcome score ( GOS) comparison half a year later showed that the control group had 17 cases of good prognosis, while the improved group had 29 cases, which had statistically significance (P < 0.05).
Conclusion: Improved method proved to be an excellent technique on hematoma evacuation in craniectomy in patients with severe brain injury, especially in the prevention and treatment of intraoperative brain swelling, clearance of bloody cerebrospinal fluid and continuously reduce the intracranial pressure. A positive neurological outcome and decreased mortality was also observed in the improved group.
Manuscripts that are Published Ahead of Print have been peer reviewed and accepted for publication by the Editorial Board of the West Indian Medical Journal. They may appear in their original format and may not be copy edited or formatted in the style guide of this Journal. While accepted manuscripts are not yet assigned a volume, issue or page numbers, they can be cited using the DOI and date of e-publication. See our Instructions for Authors on how to properly cite manuscripts at this stage. The contents of the manuscript may change before it is published in its final form. Manuscripts in this section will be removed once they have been issued to a volume and issue, but will still retain the DOI and date of e-publication.
Our 7 faculties and 12 professional schools offer more than 200 programmes to some 18,000 graduate, undergraduate and continuing studies students.
The UWI, Mona ranks first in Jamaica among accredited tertiary-level programmes. In 2012, the University was again one of Jamaica’s Top 100 Employers.
