European Journal of Molecular & Clinical Medicine

Introduction: Traumatic Brain injury is defined as an acute injury to the head caused by blunt or penetrating trauma or from acceleration/deceleration forces excluding degenerative, congenital problems. Decompressive craniectomy is being used as an effective measure in the management of TBI with prognosis being measured in terms of Glassgow outcome scale. However, the quality of life of such patients is often not assessed. Quality of life is a long term outcome phenomenon which must be effectively evaluated.
Objectives: To assess the quality of life of the patients undergoing decompressive craniectomy using EQ5D scoring scale.
Materials and Methods: This was an observational study conducted for 1.5 years in a Trauma care centre of Eastern India. The study included 100 study subjects. Informed consent was obtained from every participant and approval to conduct the study was obtained from Institutional ethics Committee.All post trauma patients who survived after decompressive craniectomy were followed up at 6 months post discharge to assess their quality of life using a pre-designed and pre-tested proforma containing information on the clinical profile. Quality of life was analyzed using the EQ5D scoring system at six months of discharge.
Results: The mean  SD age of the study subject was calculated to be 51.5  23.3 years. The commonest mode of injury was road traffic accident seen in 62% study participants. Almost 3/4^th of the study subjects underwent surgery for non-diffuse traumatic brain injury within the first 24 hours of hospital admission. Among the 72 study participants that survived, EQ5D Index score to assess the quality of life was found good/ favorable in 86.1% patients and only 13.9% subjects had a poor/ unfavorable EQ5D Index score.
Conclusion: Majority of survivors after decompressive craniectomy showed a good functional outcome as analyzed by EQ5D. Improving patient selection and optimizing timing of the procedure may lead to favorable long term functional outcome in these very severely brain injured patients.

Aim and Objective: To evaluate the outcome of the poor GCS patients operated for Acute
subdural hematoma with decompressive craniotomy alone vs decompressive craniotomy with
cisternostomy.
Materials and Methods:Fifty four consecutive cases of poor GCS of Acute SDH were operated
at Medical College Hospital by decompressive craniotomy alone vs decompressive craniotomy
with cisternostomy in order to assess the outcome.
Observation and Results:Fifty four patients divided in 2 groups of 27 patients each consisting
of 21 males and 6 females in each group were randomly selected. Mean age of the patients in
group A was 42.25 years (Range: 19 - 72 years) and Group B was 50.33 years (Range: 28 - 71
years).In group A mortality was 33.33% and in group B mortality was 11.11%.
Conclusion: We may conclude in our study that patients with cisternostomy with
decompressive craniotomy have better prognosis than patients with decompressive craniotomy
alone in view of mortality and morbidity