Acute severe traumatic brain injury with high risk factors for contralateral epidural hematoma expansion
Conditions
Interventions
Experimental group:Prophylactic contralateral middle meningeal artery embolization followed by ipsilateral craniotomy for hematoma evacuation and/or decompressive craniectomy.
Sponsors
Northern Jiangsu People's Hospital, Jiangsu Province, China
Eligibility
Sex/Gender
All
Age
18 Years to 80 Years
Inclusion criteria
Inclusion criteria: 1. Age range: 18 to 80 years old, gender not restricted; 2. History of closed head trauma, with the time from injury to admission 5 mm, etc.; 4. The contralateral side of the head has a small epidural hematoma (less than 20 ml) confirmed by the first head CT scan, or there is a temporal-parietal skull fracture crossing the middle meningeal artery groove; 5. GCS score at admission: 3 - 8; 6. Family members or legal representatives have signed the informed consent form.
Exclusion criteria
Exclusion criteria: 1. There is clear primary brainstem injury or the expected survival period is less than 24 hours; 2. Both sides have reached the surgical indications that require immediate craniotomy before the operation; 3. Severe coagulation dysfunction, such as platelet count < 50×10^9/L and unable to be corrected within a short period of time; 4. There are contraindications for cerebral angiography or embolization, such as severe allergy to contrast agent; 5. Pregnant or lactating women.
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| Incidence of decompressive contralateral epidural hematoma expansion resulting in severe brain swelling or rescue surgery during surgery or within 72 hours after surgery; | — |
Countries
China
Contacts
Public ContactXingdong Wang
Northern Jiangsu People's Hospital, Jiangsu Province, China
Outcome results
None listed