OBJECT: It is generally believed that the outcome of traumatic brain injury is not improved by decompressive craniectomy in patients older than 30-50 years. A literature search was performed to assess the level of evidence with respect to the effect of age on outcome in these cases. METHODS: References were identified by PubMed searches of journal articles published between 1995 and December 2008. The inclusion criteria were as follows: 1) clinical series including adults; and 2) focus on age as a prognostic factor. Technical notes and laboratory investigations were excluded. RESULTS: Fourteen English-language articles were finally selected. In 5 of the 14 studies, the authors performed no statistical analysis. In 6 studies they concluded that age was not significantly related to outcome (with 1 of these studies showing a correlation between age and outcome only after 65 years). Three studies showed a correlation between age and outcome. CONCLUSIONS: With respect to age and effectiveness of decompressive craniectomy, there are no robust data to establish any degree of core evidence and the referred age thresholds are arbitrary.
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Data di pubblicazione: | 2010 | |
Titolo: | Decompressive craniectomy for the treatment of traumatic brain injury: does an age limit exist? | |
Autori: | De Bonis, Pasquale; Pompucci, Angelo; Mangiola, Annunziato; D'Alessandris, Q Giorgio; Rigante, Luigi; Anile, Carmelo | |
Rivista: | JOURNAL OF NEUROSURGERY | |
Parole Chiave: | Adolescent; Adult; Age Factors; Brain Injuries; Craniotomy; Female; Humans; Male; Middle Aged; Young Adult; Decompression, Surgical | |
Abstract: | OBJECT: It is generally believed that the outcome of traumatic brain injury is not improved by decompressive craniectomy in patients older than 30-50 years. A literature search was performed to assess the level of evidence with respect to the effect of age on outcome in these cases. METHODS: References were identified by PubMed searches of journal articles published between 1995 and December 2008. The inclusion criteria were as follows: 1) clinical series including adults; and 2) focus on age as a prognostic factor. Technical notes and laboratory investigations were excluded. RESULTS: Fourteen English-language articles were finally selected. In 5 of the 14 studies, the authors performed no statistical analysis. In 6 studies they concluded that age was not significantly related to outcome (with 1 of these studies showing a correlation between age and outcome only after 65 years). Three studies showed a correlation between age and outcome. CONCLUSIONS: With respect to age and effectiveness of decompressive craniectomy, there are no robust data to establish any degree of core evidence and the referred age thresholds are arbitrary. | |
Digital Object Identifier (DOI): | 10.3171/2009.7.JNS09505 | |
Handle: | http://hdl.handle.net/11392/2368208 | |
Appare nelle tipologie: | 03.1 Articolo su rivista |