ORIGINAL RESEARCH article
Front. Neurol.
Sec. Neurocritical and Neurohospitalist Care
Volume 16 - 2025 | doi: 10.3389/fneur.2025.1574036
The efficacy of controlled stepped intracranial decompression surgery in patients with craniocerebral injury
Provisionally accepted
- The Second People's Hospital of Quzhou, Quzhou, China
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Background: Head injuries are frequently the result of high-energy trauma, which is often severe and has a high mortality rate. Methods: This retrospective study included 78 patients with severe traumatic brain injury treated from January 2021 to January 2023. Patients were divided into two groups: a control group (n = 33) treated with standard large bone flap decompression, and a research group (n = 45) treated with controlled stepwise intracranial decompression. Surgical parameters, treatment efficacy, complications, neurological function, and serum biomarkers (IL-6, CRP, NSE) were compared. Multivariate logistic regression was adjusted for confounders.received Results: The research group had significantly shorter decompression initiation times, reduced operation durations, and less intraoperative blood loss (P < 0.05). The effective treatment rate was higher in the research group (80.0% vs. 57.6%, P < 0.05). After treatment, both groups showed improvements in NFD and GCS scores, with more significant improvement in the research group (P < 0.01). Inflammatory markers (IL-6, CRP, NSE) decreased post-treatment in both groups, with significantly lower levels in the research group (P < 0.01). The complication rate was markedly lower in the research group (8.9% vs. 30.3%, P < 0.05). Multivariate analysis confirmed that stepwise decompression was associated with higher clinical efficacy (aOR = 3.20, 95% CI: 1.24–8.28, P = 0.016) and fewer complications (aOR = 0.24, 95% CI: 0.07–0.82, P = 0.022). treatment, and NSE levels of the 2 groups were less than those after therapy (P < 0.05); and the blood IL-6, CRP, and NSE levels of the research group after treatment were greater than those of the control group Conclusions: Controlled stepped intracranial decompression surgery could effectively shorten the operation time of sufferers with severe craniocerebral injury, reduce intraoperative blood loss, improve clinical treatment effects, improve patient prognosis, and promote neurological recovery.
Keywords: Craniocerebral injury, controlled stepwise intracranial decompression, standard large bone flap decompression, efficacy, Surgery
Received: 10 Feb 2025; Accepted: 22 Apr 2025.
Copyright: © 2025 Huang, Yu, Liao, Dong, Zheng and Zhang. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence:
Xiaobin Huang, The Second People's Hospital of Quzhou, Quzhou, China
Shanchi Zhang, The Second People's Hospital of Quzhou, Quzhou, China
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