Objective: This randomized study was designed to investigate the safety and efficacy of surgical incision of the cerebellar tentorium in the treatment of transtentorial herniation after traumatic brain injury.Subjects and Methods: Surgical incision of the cerebellar tentorium was performed after the evacuation of intracranial hematoma in 92 patients (study group). Conventional decompressive craniotomy and hematoma evacuation were performed in 90 patients (control group) in the same period of time. Postoperational Doppler ultrasound was performed to detect vasoconstriction of the posterior cerebral artery.Results: There was no significant difference in age, sex, location of intracranial hematoma or other brain injuries, or preoperational Glasgow Coma Scale (GCS) between the study and the control group (P>0.05). There was no significant difference in the rate of individual complications between the 2 groups (P>0.05). However, the overall percentage of patients who experienced postoperational complications in the control group was higher than in the study group (45.6% vs. 19.6%, P=0.047). Patients were followed up between 5 to 60 months. The Glasgow Outcome Scale (GOS) 5 was achieved in 60.5% of the study group and in 29.1% of the control group (P<0.01). GOS 2 was found in 9.3% of the study group and in 24.1% of the control group (P<0.01). The mortality rate in the study group was lower than in the control group (5.4% vs. 12.2%, P<0.05).Conclusion: Surgical incision of the cerebellar tentorium is a safe and effective therapeutic strategy for transtentorial herniation after severe traumatic brain injury.
|Number of pages||4|
|Publication status||Published - Feb 2012|