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Operative treatment of temporal lobe contusion

Operative treatment of temporal lobe contusion

Intensivmedizin 19(1): 11-18

Temporal lobe contusion is usually caused by contre coup head injury and only occasionally by direct trauma. The damaged brain region can by resorbed and may become cystic. The contusion can occupy space by bleeding and perifocal edema. When CSF in the neighborhood of the swollen temporal region of the brain is dispersed the final outcome may be poor due to brainstem compression. In cases of large space occupying temporal lobe contusions with bleeding the operative resection of the necrotic tissue is adequate therapy. This principle was demonstrated experimentally. Adult cats received a standardized cold-induced brain edema; the animals with resection of the edema had the best survival rate. In the clinical management of brain injury the indications for operative intervention can be obtained from clinical progress, CT [computed tomography] scan and continuous recording of intracranial pressure [ICP]. Recording of ICP and timing and method of surgical therapy is described and illustrated by typical cases. Surgical therapy is described and illustrated by typical cases. Surgical therapy is by resection of all damaged brain tissue right down to the temporal base of the skull. If only the temporal region is traumatized, this therapy has a good prognosis for the patient.

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Accession: 006036070

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