The outcome from severe head injury with early diagnosis and intensive management

In the belief that secondary cerebral compression, hypoxia, and ischemia materially influence the outcome from severe head injury, a standardized protocol was followed in 160 patients, with emphasis on early diagnosis and evacuation of intracranial mass lesions by craniotomy, artificial ventilation,...

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Bibliographic Details
Published inJournal of neurosurgery Vol. 47; no. 4; p. 491
Main Authors Becker, D P, Miller, J D, Ward, J D, Greenberg, R P, Young, H F, Sakalas, R
Format Journal Article
LanguageEnglish
Published United States 01.10.1977
Subjects
Adolescent
Adult
Age Factors
Aged
Brain Injuries - diagnosis
Brain Injuries - physiopathology
Brain Injuries - therapy
Child
Child, Preschool
Female
Humans
Intensive Care Units - methods
Male
Middle Aged
Prognosis
Sex Factors
Time Factors
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Summary:In the belief that secondary cerebral compression, hypoxia, and ischemia materially influence the outcome from severe head injury, a standardized protocol was followed in 160 patients, with emphasis on early diagnosis and evacuation of intracranial mass lesions by craniotomy, artificial ventilation, control of increased intracranial pressure, and aggressive medical therapy. Of these patients, 36% made a good recovery, 24% were moderately disabled, 8% were severely disabled, 2% were vegetative, and 30% died. The mortality rate compares favorably with outcomes in similar patients reported from other centers and there has been no increase in the numbers of severely disabled or vegetative patients. It is proposed that vigorous surgical and medical therapy, by preventing or reversing secondary cerebral insults, enables some patients who would have died to make a good recovery without increasing the proportion of severely disabled patients.
ISSN:0022-3085
DOI:10.3171/jns.1977.47.4.0491