Risk factors of unfavorable outcome after decompressive craniectomy in children with severe traumatic brain injury

doi:https://doi.org/10.17116/neiro20258903142

Journal: . 2025;89(3): 42‑47

DOI: 10.17116/neiro20258903142

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To cite this article:

Risk factors of unfavorable outcome after decompressive craniectomy in children with severe traumatic brain injury. . 2025;89(3):42‑47. (In Russ., In Engl.)
https://doi.org/10.17116/neiro20258903142

Подписка 2025 Журнал «Вопросы нейрохирургии» имени Н.Н. Бурденко (Burdenko's Journal of Neurosurgery)

Использование инфографики авторами научных работ

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OBJECTIVE

To identify the risk factors of unfavorable outcomes after decompressive craniectomy in children with severe TBI.

MATERIAL AND METHODS

The study included 64 patients with refractory intracranial hypertension over 20 mm Hg. Age, GCS score at admission, GOS grade after 6 months, intracranial pressure and cerebral perfusion pressure before surgery, energy of ICP fluctuations process-E², pupil status and ISS score were analyzed. Treatment outcomes were assessed after 6 months.

RESULTS

GOS grade 4—5 was observed in 45.3% of cases, grade 3 — in 31% of cases, grade 1—2 — in 23.4% of cases. Mortality rate was 18.7% (12 patients). There are significant predictors of unfavorable outcome: GCS score, ICP ≥40 mm Hg, wide pupils, impaired photoreaction, type of injury (isolated/combined), midline shift (p<0.05).

CONCLUSION

Risk factors of unfavorable outcome after decompressive craniectomy in children include independent factors (severity of primary brain injury) and controllable factors (ICP and its derivatives). ICP ≥40 mm Hg increases the risk of unfavorable outcome after decompressive craniectomy. Decompressive craniectomy is a preventive measure and should be considered as a tool for dislocation syndrome control.

Keywords:

traumatic brain injury

decompressive craniotomy

children

intracranial pressure

outcomes

Received:

24.02.2025

Accepted:

28.03.2025

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