![]() This retrospective study was performed on 256 patients who underwent surgery after being diagnosed with isolated traumatic ASDH at our neurosurgical department between April 2013 and December 2020. In this study, we aimed to explore the risk factors for intraoperative acute diffuse brain swelling in patients with isolated traumatic ASDH. This information is urgently needed in clinical work to estimate the incidence of intraoperative acute diffuse brain swelling based on preoperative clinical and imaging data, and this information can help neurosurgeons accurately determine the surgical risk and to provide reasonable suggestions to patients’ families. However, few reports have evaluated the risk factors for intraoperative acute diffuse brain swelling in patients with isolated traumatic ASDH. This situation is a significant concern for all neurosurgeons. Acute diffuse brain swelling during DC is often accompanied by an acute drop in blood pressure, and the mortality is very high. Neurosurgeons can manage remote intracranial haematomas by contralateral craniotomy but are often struggle to manage diffuse brain swelling due to a lack of an effective treatment method. Acute diffuse brain swelling is one of the leading causes of intraoperative acute encephalocele, and it also has the highest mortality. The main causes of acute encephalocele include a contralateral subdural haematoma, a contralateral epidural haematoma and acute diffuse brain swelling. Acute encephalocele is a very dangerous and urgent situation during DC. Decompressive craniectomy (DC) is recommended when patients have a decreased level of consciousness, a greater size of the haematoma, a midline shift, or a basal cistern obliteration. These findings should help neurosurgeons obtain information before surgery about intraoperative acute diffuse brain swelling in patients with isolated traumatic ASDH.Īcute subdural haematoma (ASDH) is a common and serious injury in traumatic brain injury (TBI) patients. An increased risk of intraoperative acute diffuse brain swelling occurs in patients with bilaterally dilated pupils, subarachnoid haemorrhage and a shorter time from injury to surgery. This study identified the risk factors for intraoperative acute diffuse brain swelling in patients with isolated traumatic ASDH. Dilated pupils (OR = 24.78), subarachnoid haemorrhage (OR = 2.41), and the time from injury to surgery (OR = 0.32) were independent risk factors for intraoperative acute diffuse brain swelling, while no independent associations were observed between these risk factors and sex, age, the mechanism of injury, the Glasgow Coma Scale score, site of haematoma, thickness of haematoma, midline shift and the status of the basal cistern, although the mechanism of injury, the Glasgow Coma Scale score and the status of the basal cistern were correlated with the incidence of intraoperative acute diffuse brain swelling in the univariate analyses. The incidence of intraoperative acute diffuse brain swelling in patients with isolated traumatic ASDH was 21.88% (56/256). We evaluated the risk factors for intraoperative acute diffuse brain swelling using a multivariate logistic regression analysis. ![]() MethodsĪ total of 256 patients who underwent decompressive craniectomy for isolated traumatic ASDH between April 2013 and December 2020 were included. The purpose of this retrospective study was to investigate the risk factors for intraoperative acute diffuse brain swelling in patients with isolated traumatic acute subdural haematomas (ASDH).
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