Effects of cisternostomy with cisternal drainage and subdural drainage on intracranial pressure and prognosis in patients with severe traumatic brain injury after decompressive craniectomy
Shao Shuangwei
Li Fan
Li Jianhong
Wang Wei
Yang Tao
Abstract：Objective To analyze the effects of cisternostomy with cisternal drainage and subdural drainage on intracranial pressure(ICP)and prognosis in patients with severe traumatic brain injury(sTBI)after decompressive craniectomy.Methods A total of 82 patients with sTBI who underwent decompressive craniectomy between January 2022 and December 2023 were selected as the study subjects,and divided into group A(cisternostomy with cisternal drainage,n=41)and group B(subdural drainage,n=41)according to the random number table method.Postoperative mechanical ventilation time,length of hospital stay,and infection rate were recorded.Comparisons were made between the two groups in terms of postoperative ICP at multiple time points,GCS scores on days 1,3,5,7,and 14,blood lactate levels before and after surgery,as well as Rotterdam CT and mRS scores.Results There were no statistically significant differences between the two groups in postoperative mechanical ventilation time,length of hospital stay,or intracranial infection rate(P＞0.05).Group A had lower ICP than group B at 6 h,12 h,24 h,48 h,and 72 h after surgery(P＜0.05).The two groups had similar blood lactate levels before surgery(P＞0.05).At 24 h and 72 h after surgery,blood lactate levels in both groups decreased,and the level in group A was lower than that in group B(P＜0.05).The two groups had similar GCS scores before surgery and on day 1 and day 3 after surgery(P＞0.05).Group A had significantly higher GCS scores than group B on day 5,day 7 and day 14 after surgery(P＜0.05).The two groups had similar Rotterdam CT scores before surgery(P＞0.05).At 48 h after surgery,Rotterdam CT scores of both groups decreased,and group A had lower scores than group B(P＜0.05).Preoperative mRS scores of the two groups were comparable(P＞0.05).At 3 months post-surgery,both groups showed decreased mRS scores,with group A exhibiting significantly lower scores than group B(P＜0.05).Conclusion Compared with subdural drainage,cisternostomy with cisternal drainage has more advantages in reducing ICP and improving prognosis in patients with sTBI after decompressive craniectomy.
Keywords：Severe traumatic brain injuryCisternostomy with cisternal drainageSubdural drainageIntracranial pressurePrognosisDecompressive craniectomy
Publication Date：2025-08-31
Online Publishing Date：2025-09-24(First online date of this platform, not the publication date of the document)
Pages：5( 630-634 )