Concurrent Surgery of Craniectomy and Splenectomy as Initial Treatment in Severe Traumatic Head Injury: A Case Report

다국어 초록 (Multilingual Abstract)

It is not a common case for neurosurgery department and the other departments to perform joint operation at the sametime. Patients with severe head injury are a condition in which vital signs are unstable due to severe brain swelling and increased intracranial pressure, and emergency surgery is required. A 44-year-old man visited the trauma center with a motorcycle accident. The Glasgow Coma Scale score at the time of emergency department was 3 points, and the pupil wasfxed at 6 mm on both sides. His medical history was unknown. His vital signs including blood pressure (BP), heart rate,respiratory rate and oxygen saturation were stable. Associated injuries included multiple fractures of whole body. Braincomputed tomography revealed subarachnoid hemorrhage, intraventricular hemorrhage and severe cerebral edema. During the preparation of the craniectomy, abdominal ultrasonography performed because of decreased BP resulted in a largeamount of hemoperitoneum. The bi-coronal craniectomy and splenectomy were performed simultaneously for about 4hours. After ffty days of treatment, he was discharged with Glasgow Outcome Scale-extended 4 points and is undergoingrehabilitation. In severe polytrauma patients, active concurrent surgery is a good method to save their lives.