A Comparative Study To Analyse The Effectiveness Of Basal Cisternostomy Combined With Decompressive Craniectomy And Decompressive Craniotomy Alone, It's Impact On The Outcome Of Moderate And Severe Head Injury Patients

Abstract

Introduction- Severe traumatic brain injury (TBI) is a life-threatening condition which is associated with substantial morbidity and mortality. Cisternostomy is a novel surgical technique that has been proposed to prevent the development of secondary brain injury and treat associated increase in intracranial pressure. Decompressive craniectomy has been shown to reduce ICP, but it actually provides an outlet for brain tissue to expand without reducing edema. cisternostomy is associated with an improved outcome (both at early and long term), improved brain oxygenation, better control of ICP and shorter ICU stay when compared to standard decompressive craniectomy.

Aims and Objectives- to assess effectiveness of Basal cisternostomy surgery with Decompressive Craniotomy surgery ,it’s impact and outcome post operative complication , morbidity ,mortality in moderate and severe brain injury.

Material and methods- All enrolled patients were randomly assigned to 2 groups and assessed clinically and radiologiacally.TBI were categorised as mild, moderate and severe according to marshall CT based score. Outcomes were assessed based on Glasgow coma outcome scale on follow up.

Results- Total of 50 patients were randomly assigned (25 patients in each group). Patients in cisternostomy group had decreased mean duration days of ventilator support and ICU stay significant decreased in mobidity   and low rate of complications in cisternostomy group.

Conclusions- Cisternostomy was effective in reducing mortality, mobidity and complications post operatively. Glascoma outcome scale and Marshall score had a significant prognostic impact in management of TBI.