Evaluation of pupil diameter and midline shift in patients undergoing decompressive craniectomy

Abstract

Aim: Intracranial pressure may increase due to reasons such as head trauma, intracranial hematoma, cerebral infarction, and cerebral edema. Decompressive craniectomy (DC) may be preferred in the treatment. Our study aims to examine the time of DC and the effect of pupil diameter and midline shift on mortality. Methods: Data from the hospital automation system and patient file records were retrospectively reviewed between 2017 and 2019, and 57 patients who underwent DC for raised intracranial pressure. Fifty-seven patients who underwent DC, whose neurological examination and pupil diameter were recorded after increased intracranial pressure, were evaluated. Results: The mean age of 57 patients was 50.38±19.91 years. The patients’ mean preoperative Glasgow coma score (GCS) was 8.85±3.6 and the mean GCS at discharge was 8.96±6.0. The mean cranial midline shifts of the patients were 7.88±5.35. 49.1% of the patients who underwent DC survived. Conclusion: Mortality rate is lower in patients who underwent DC compared to patients with isochoric pupil, anisocoric, and mid dilated patients. The timing of DC is important in terms of its effect on mortality.