ABSTRACT

Objective: To see the efficacy or safety of managing traumatic brain injury under local anesthesia.

Study Design: Retrospective cohort study.

Place and Duration of Study: Department of Neurosurgery, Liaquat University Hospital Hyderabad from 1st December 2017 to 31st December 2018.

Methodology: Ten patients of all males between 20 to 55 years of age were included. The data was collected from the patients that went through emergency surgery or showed drop of more than three GCS. The data was collected through questionnaire based approach in three phases of whole time duration .i.e. preoperative, post operative with three month follow up.

Results: The extra-dural hematoma (80%) and combination of extra-dural hematoma with acute subdural hematoma (20%). Improvement of GCS from initial moderate to severe GCS (90%), improvement of non-radiological vitals, systolic blood pressure (70%), heart rate (90%), respiration rate (80%), eye pupil size (70%), improvement of neurological deficit (33%) with improvement in radiological variables, midline line shift reversal (100%), removal of hematoma (100%), improvement in volume on scan (100%) and reversal of Cisterns and sulci (100%). Post-operative complication includes iatrogenic pnemocephalus (100%), new hematoma or contusion (10%) and ischemia or infarct (20%) which was resolved within 5 to 7 days post operatively .i.e. pnemocephalus (90%), hematoma (100%) and ischemia or infarct (50%) with total of (90%) clinical and functional outcome. At the time of discharge, headache (50%), numbness (20 %), pain at surgical side (70%) and vertigo (50%), which were subsequently improvement of headache (100%), numbness (100%), pain at surgical side (57%) and vertigo (50%) due to conservative management up to three month follows up.

Conclusion: Conventional craniotomy under local anesthesia should be initial approach for early relive in extra-dural hematoma with or without acute subdural hematoma.

Key words: Outcome, Conventional craniotomy, Traumatic brain injury