Đặc điểm lâm sàng, cắt lớp vi tính sọ não ở bệnh nhân bị khuyết sọ sau phẫu thuật mở sọ giảm áp tại Bệnh viện Quân y 103

Traumatic brain injury (TBI) represents a significant global health challenge, frequently necessitating decompressive craniectomy (DC) to manage elevated intracranial pressure. While DC is a life-saving intervention, it often results in patients developing cranial defects, leading to a spectrum of neurological and psychological sequelae. A thorough understanding of the clinical characteristics and imaging findings associated with these defects is crucial for optimizing patient management, guiding the timing of cranioplasty, and predicting functional outcomes. This study, conducted at Military Hospital 103, aims to meticulously detail the clinical presentation and computed tomography (CT) findings in patients who develop cranial defects following decompressive craniectomy, thereby contributing vital insights to improve current management strategies and rehabilitation protocols.

Neurosurgeons, neurologists, radiologists, medical researchers, and healthcare professionals involved in neurotrauma and critical care, particularly in Vietnam or similar settings.

This study comprehensively investigates the demographic, etiological, clinical, and radiological profiles of patients developing cranial defects following decompressive craniectomy (DC). A cross-sectional descriptive study was conducted on 70 patients at Military Hospital 103 between October 2023 and February 2025. Data encompassed patient demographics, indications for DC, clinical manifestations such as focal neurological deficits and Glasgow Coma Scale (GCS) scores, and detailed computed tomography (CT) findings concerning the morphology, location, and size of the cranial defects. Key findings revealed that the patient cohort predominantly consisted of middle-aged men (mean age 43.3 years, 80% male), with traumatic brain injury being the leading cause for DC (64.3%). Clinical examination frequently identified focal neurological deficits (35.7%), and most patients presented with favorable preoperative GCS scores (GCS 15 in 51.4%). Radiological assessment via CT confirmed that skull defects were overwhelmingly located in the hemisphere region (97.1%) and were typically large (>75 cm² in 77.1% of cases), with a majority classified as "normal" morphologically (64.3%). These results underscore the demographic patterns susceptible to severe head trauma and highlight the common features of post-DC cranial defects. The insights gained are invaluable for clinicians at Military Hospital 103 and similar facilities, aiding in the anticipation of patient profiles, optimizing surgical and reconstructive planning, and enhancing post-operative care. This comprehensive understanding is crucial for improving long-term patient outcomes and informing rehabilitation strategies for individuals with decompressive craniectomy-related cranial defects.