Title:a Study Of Decompressive Craniectomy With Middle/Large Bone Flap Of Severe Cerebral Contusion In Unilateral Frontal And Temporal Lobes

Objective:To investigate the short and long term effect of decompressive craniectomy with middle/large bone flap of severe cerebral contusion in unilateral frontal and temporal lobes.Methods:Intracranial pressure (ICP) monitoring were placed in36cases of GCS3-8with severe cerebral contusion in unilateral frontal and temporal lobes after decompressive craniectomy, and then divided them into two groups according to size of bone flap, the large-flap group and middle-flap group. Changes of ICP, midline shift and basal cistern were observed to determine short term effect, and GOS after3month to determine long term effect.Results:Both groups showed significant ICP decrease after decompressive craniectomy; ICP of middle-flap group was higher than that of large-flap group on the3rd postoperative day, had no significant difference on the all days. Changes of midline shift and basal cistern were significant after operation, and there were no differences between groups, as well as postoperative complications.Conclusions:Decompressive craniectomy with bone flap of severe cerebral contusion in unilateral frontal and temporal Lobes is effective in decreasing ICP, improving imaging manifestation, reducing mortality and disability rate, and improving prognosis of short and long term. No difference was found between middle and large flap groups.