Emergency re-craniotomy after selected neurosurgical operations:analysis of clinical features in a s

• 作 者: Runfa Tian Shuyu Hao Zonggang Hou Junting Zhang Liwei Zhang Baiyun Liu
• 机 构: Department of Neurosurgery, Beijing Tian Tan Hospital, Capital Medical University, Beijing 100050, C
• 出 处: 2016全国神经损伤大会暨第五届天坛全国神经创伤学术研讨会
• 发表日期: 2016年12期
• 关键词: Clinical feature Neurosurgery Emergency re-craniotomy Selective operation

　　An emergency re-craniotomy after neurosurgery is serious and has a potentially devastating effect on patient outcomes.We aimed to characterize the clinical features of the patients who underwent an emergency re-craniotomy after the selected neurosurgery.We reviewed the clinical manifestations, treatment and prognosis of a series of 110 cases that underwent emergency re-craniotomies after elective surgery in Beijing Tian Tan Hospital,Capital Medical University, Beijing, China, between Dec 2009 and Nov 2011.There were 110 cases in this study, with a mean age of 45.5 years and with the age group of 50-59 accounting for the highest proportion (29/110, 26.4%).These cases accounted for 1.6% of the total elective surgery cases during the same period in our hospital The most common primary symptom before an emergency re-craniotomy in our cohort was unconsciousness in 49 patients (44.5%), followed by not returning to consciousness following the operation in 17 patients (15.5%) and headache in 10 patients (9.1%).The two periods of 0-8 hours (31/110, 34.4%) and 25-48 hours (18/110, 16.4%) after surgery showed bimodal characteristics for the time distribution of the emergency re-craniotomies.The most common reason for an emergency re-craniotomy was a hematoma or hematoma with a contusion and laceration after the initial surgery.After the second operation, 46.4% of the patients lived a normal life, 20.9% were mildly disabled, and 11.8% were in a vegetative state or died.In conclusion, for inpatients that are indicated for surgery, perioperative management should be reinforced to decrease the necessity of performing emergency re-craniotomies.