Title

The use of lobectomy in the management of severe closed-head trauma

UMMS Affiliation

Information Services, Academic Computing Services; Department of Cell Biology

Date

4-1-1994

Document Type

Article

Subjects

Adult; Cerebral Cortex; Encephalocele; Female; Follow-Up Studies; Glasgow Coma Scale; Head Injuries, Closed; Humans; Male; Middle Aged; Neurologic Examination; Postoperative Complications; Pseudotumor Cerebri; *Psychosurgery; Retrospective Studies; Survival Rate

Disciplines

Neurology | Surgery

Abstract

A retrospective review is presented of 20 patients with traumatic brain injury who were treated during the course of their illness by lobectomies either after a herniation or other significant deterioration or to reduce elevated intracranial pressure. All the patients suffered from blunt head trauma. Patient ages ranged from 19 to 59 years (average, 34 yr). The initial Glasgow Coma Scale score ranged from 3 to 15 (average, 8.2). There were 14 frontal lobectomies, 2 temporal, 3 frontal and temporal, and 1 occipital. Surgery was performed between 0 and 8 days after injury (average, 2.8). Outcome was favorable (good or moderately disabled) in 11 patients and unfavorable (severely disabled, persistently vegetative, or dead) in 9. No patients survived in a persistently vegetative state. A higher initial Glasgow Coma Scale score was positively correlated with a more favorable outcome (P < 0.03). Younger patients also showed a significant positive relationship to outcome (P < 0.0005). Better pupillary reactivity showed a significant trend toward a more favorable outcome (P < 0.04). The type of lesions identified on computed tomographic scans had no association with outcome. A lobectomy can be a useful adjuvant in the management of severe brain injury, especially in younger patients with relatively higher initial Glasgow Coma Scale scores who subsequently deteriorate or develop elevated intracranial pressure.

Rights and Permissions

Citation: Neurosurgery. 1994 Apr;34(4):628-32; discussion 632-3.

Related Resources

Link to article in PubMed

PubMed ID

8008159