Scroll Up
Scroll Down
Play Play Play Play
Unregistered User
Click here if this is not your Personal Edition
 
Contact Us | Free E-Mail Updates | Journals | Register a colleague
 
 
Neurologic Other
 
   
 
SEARCH   
Doctor's Guide Free CME
Medline
Congress Resource Centre
 

 EXPLORE :
   Most Read News
 All News  All News
 All Webcasts / CME  All Webcasts / CME
 All Cases  All Cases
 Congress Resource Centre  Congress Resource Centre
 All Medical Resources  All Medical Resources
 Medical  My Personal Edition



Warning | Privacy

 

 
 Recent news - Neurologic Other
    Modafinil Improves Cognitive Performance in Breast Cancer Survivors: Presented at AGS - (DGDispatch)
    Chromosome 6p22 Locus Associated with Clinically Aggressive Neuroblastoma - (N Engl J Med)
    Vasopressin-Receptor Antagonists May Help Treat Wide Range of Conditions - (DGNews)
    Corticosteroids and mortality in children with bacterial meningitis - (JAMA)
    US Guidelines: Botulinum Toxin Effective in Many Neurological Disorders, Not Headache - (DGNews)

    News archive

     Recent webcasts/CME - Neurologic Other
    • Dementia in Hispanic Americans: The Reasons Behind the Risk
    • Modifiable Risk Factors Underlie Higher Dementia Rates in African Americans
    • Battling Chronic Fatigue Syndrome
      Brain Cooling for the Treatment of Perinatal Hypoxic-Ischemic Encephalopathy
      Delirium Update

      Webcasts/CME archive

       Recent cases - Neurologic Other
        Spinal Dural Arteriovenous Fistula: A Treatable Cause of Myelopathy
        Kernicterus by Glucose-6-Phosphate Dehydrogenase Deficiency: A Case Report and Review of the Literature
        Delayed Spinal Extradural Hematoma Following Thoracic Spine Surgery and Resulting in Paraplegia: A Case Report
        Bilateral Superficial Peroneal Nerve Entrapment Secondary to Anorexia Nervosa: A Case Report
        A Ganglion Cyst at the Elbow Causing Superficial Radial Nerve Compression: A Case Report

        Cases archive
          




        my personal edition > neurologic other > news
        divider

          E-Mail this DGDispatch to a colleague

        DGDispatch


        Craniectomy an Option for Treatment of Traumatic Brain Injury: Presented at AANS

        By Mary Beth Nierengarten

        CHICAGO -- May 5, 2008 -- For patients with traumatic brain injury, treatment with craniectomy is a viable option over craniotomy and may be associated with improved outcomes in patients with more severe injuries, reported investigators in a poster presentation at the 76th Annual Meeting of the American Association of Neurological Surgeons (AANS).

        To compare outcomes in a matched group of patients treated by craniectomy or craniotomy, researchers conducted a retrospective review of data on 95 patients who had undergone craniectomy (n = 37) or craniotomy (n = 58) at their institution between 2002 and 2006.

        Principal author Jeffrey Catrambone, MD, Associate Professor of Department of Neurological Surgery, New Jersey Medical School, University of Medicine and Dentistry of New Jersey, Newark, New Jersey, presented the findings in a poster session April 26 to May 1.

        Comparison of the 2 treatment approaches was based on the severity of injury upon admission using the Glasgow Coma Scale (GCS), outcomes of treatment at follow-up using the Glasgow Outcome Scale (GOS) score, and survival. A separate analysis was also done to assess outcomes based on severity of the brain injury by stratifying all patients based on injury severity -- level 1 (GCS score <7), level 2, (GCS score 8-12), and level 3 (GCS score >12).

        At a mean follow-up of 8.5 months, no significant differences were found between patients treated by craniectomy and by craniotomy for severity of injury at admission (GCS score of 8.2 vs 7.8, respectively), outcomes scores (GOS score 3.2 vs 3.1, respectively), or survival rate (32.4% vs 25.9%, respectively).

        When the patients were stratified by injury severity, however, a trend toward improved outcomes was seen in the patients treated with craniectomy. For patients with the most severe head injuries (level 1), the GOS score between patients treated with craniectomy was 3.0 versus 2.6 with craniotomy (P = .08), and for patients with level 2 injuries the GOS was 3.75 versus 3.0 (P = .07).

        According to Dr. Catrambone, the "most important general finding of the study is that in a rather large number of patients, no statistical difference was found in outcomes between craniectomy and craniotomy."

        Although the study did not find significantly improved outcomes with craniectomy over craniotomy, Dr. Catrambone said that he still prefers craniectomy and thinks there is a role for this approach.

        Currently, there is interest in "revisiting" the role of craniectomy, he said. "We are finding a resurgence in the use [of this surgical approach], in part because there is evidence of better outcomes in patients with middle cerebral strokes who get craniectomies," he said.

        [Presentation title: Craniectomy Versus Craniotomy as a Method of Treatment for Severe Head Injury: A Retrospective Study. Poster 1204]



        E-Mail this DGDispatch to a colleague   To print, use this version






        All contents Copyright (c) 1995-2008 Doctor's Guide Publishing Limited. All rights reserved.



        The NTK initiative. Physicians helping physicians identify Need-To-Know science
           Feedback
        Please rate this article: Strongly DISAGREE...Strongly AGREE NTK logo
        Question 1 - Physicians need to become aware of this information as soon as possible. Question 2 - This information is likely to have an impact on the way physicians practice medicine.
        1
        2
        3
        4
        5
        6
        7
        Send