Patients with Prior Craniectomy or Craniotomy Have No Increased Risk of Acute Hemorrhage after Mild Traumatic Brain Injury

Harald Binder, Daniel Schallmeiner, Thomas M. Tiefenboeck, Stephan Payr, Markus Winnisch, Richard Kdolsky, Stefan Hajdu, Gilbert Manuel Schwarz and Marcus Hofbauer
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Harald Binder: Department of Orthopedics and Trauma Surgery, Medical University of Vienna, Waehringerguertel 18-20, 1090 Vienna, Austria
Daniel Schallmeiner: Department of Orthopedics and Trauma Surgery, Medical University of Vienna, Waehringerguertel 18-20, 1090 Vienna, Austria
Thomas M. Tiefenboeck: Department of Orthopedics and Trauma Surgery, Medical University of Vienna, Waehringerguertel 18-20, 1090 Vienna, Austria
Stephan Payr: Department of Orthopedics and Trauma Surgery, Medical University of Vienna, Waehringerguertel 18-20, 1090 Vienna, Austria
Markus Winnisch: Department of Orthopaedics, Sacred Heart Hospital of Vienna, 1090 Vienna, Austria
Richard Kdolsky: Department of Orthopedics and Trauma Surgery, Medical University of Vienna, Waehringerguertel 18-20, 1090 Vienna, Austria
Stefan Hajdu: Department of Orthopedics and Trauma Surgery, Medical University of Vienna, Waehringerguertel 18-20, 1090 Vienna, Austria
Gilbert Manuel Schwarz: Department of Orthopedics and Trauma Surgery, Medical University of Vienna, Waehringerguertel 18-20, 1090 Vienna, Austria
Marcus Hofbauer: Department of Orthopedics and Trauma Surgery, Medical University of Vienna, Waehringerguertel 18-20, 1090 Vienna, Austria

IJERPH, 2022, vol. 19, issue 5, 1-8

Abstract: The aim of this study was to retrospectively evaluate the risk of acute hemorrhagic complications in patients after either a decompressive craniectomy or a craniotomy sustaining a recurrent mild traumatic brain injury. Furthermore, we analyze whether there is a higher risk for acute hemorrhagic complications considering patients with anticoagulation compared with patients without anticoagulation in both groups. All patients with mild traumatic brain injuries after either decompressive craniectomy or craniotomy, treated between January 2005 and December 2020 at a single level 1 trauma center, were included in this retrospective analysis. Patients were screened for intracranial bleeding after mild traumatic brain injury with computed tomography. Additionally, the type of anticoagulation and its relationship concerning the clinical outcome were assessed. A total of 188 patients who had sustained a mild traumatic brain injury were included in the study. Overall, 22 patients (11.7%) presented intracranial lesions. A bony defect (decompressive craniectomy) was present in 31 patients (16.5%). In 157 patients (83.5%) who underwent decompressive craniectomy, the bony defect was closed during a second operation. There was no significant correlation between both groups on the occurrence of intracranial bleeding ( p = 0.216). Furthermore, no difference was present between patients with and without anticoagulation ( p = 0.794) concerning acute hemorrhagic complications after recurrent traumatic brain injury. Pre-existing bony defects after decompressive craniectomy showed no higher risk for acute hemorrhagic complications after recurrent mild traumatic brain injury compared with patients who primarily underwent craniotomy. Anticoagulation did not influence the occurrence of intracranial bleeding after mild traumatic brain injury in patients with decompressive craniectomy.

Keywords: traumatic brain injury; decompressive craniectomy; craniotomy; anticoagulation; outcome (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2022
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