Journal of Korean Society of Geriatric Neurosurgery 2017;13(2):90-94.
Published online September 30, 2017.
Partial Temporal Resection for treating Traumatic Subdural Hematoma Associated with Severe Brain swelling in Elderly Patients
Jong-Won Kim , Jin-Sang Kil , Dae-Won Kim , Sung-Don Kang
Department of Neurosurgery, Institute of Wonkwang Medical Science, Wonkwang University School of Medicine, Iksan, Korea
노인 환자에서 심한 뇌부종을 동반한 외상성 경막하 혈종 치료를 위한 부분 측두엽 절제술
김종원·길진상·김대원·강성돈
원광대학교 의과대학 신경외과학교실
Abstract
Objective
Acute subdural hematoma with brain swelling has high mortality rates and poor functional outcome. For improving patients’ outcome, we added partial temporal resection to the traditional procedures and evaluated the efficacy and feasibility of this procedure.
Methods
During 24 months, 28 elderly patients who had acute subdural hematoma with severe brain swelling were treated surgically. These 28 patients divided into two groups according to whether or not they underwent partial temporal resection. Nineteen of the 28 (group A) underwent traditional surgery (decompressive craniectomy for evacuation of the hematoma and debridement of the contused brain). The remaining nine patients (group B) underwent a partial temporal resection in addition to the procedures above.
Results
In the group A, there were 13 deaths with a mortality of 68.4%. Among them, seven deaths occurred within 48 hours. The mean Glasgow Outcome Scale (GOS) score was 1.7. In the group B, there were three deaths with a mortality of 33.3%. There was one death within 48hrs. The mean GOS score was 2.1. Compared to group A, group B showed a better survival rate, however, similar functional outcome.
Conclusion
We report a partial temporal resection for treating acute subdural hematoma associated with brain swelling in elderly patients. Partial temporal resection showed a better survival rate, but, similar poor functional outcome.
Key Words: Partial temporal lobe resection, Acute subdural hematoma, Traumatic brain injury


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