To investigate the clinical efficacy of long-term continuous drainage (LCD) in treatment of ipsilateral tension subdural effusion (SE) after decompressive craniectomy (DC) in patients with severe traumatic brain injury (sTBI).

A retrospective analysis was conducted on the clinical data of 14 patients with sTBI who developed ipsilateral tension SE after DC (accounting for 19.7% of 71 sTBI patients admitted during the same period)and admitted to Department of Neurosurgery, Shenzhen Second People′s Hospital from January 2014 to January 2019. Among them, 7 patients admitted from January 2014 to August 2017 were treated with traditional methods (TT group), and 7 patients admitted from September 2017 to January 2019 were treated with LCD (LCD group). Time of SE onset post operation, treatment effects, postoperative complications were compared between the two groups. All patients were followed up for 1 year.

Fourteen sTBI patients developed tension SE at a mean time of 15.6±7.1 days after DC. The median time of disappearance of tension SE in LCD group and TT group were 21.0 d(interquartile: 6.0 d)and 69.0 d (interquartile: 65.3 d) respectively. There was significant difference between those two groups (P=0.002). In 14 patients, tension SE disappeared after treatment. There was no recurrence or intracranial infection. Nine patients developed hydrocephalus after treatment of tension SE and included 5 patients in TT group and 4 patients in LCD group. Poor wound healing was observed in 3 cases including 1 case in LCD group and 2 cases in TT group.

LCD is an effective treatment for sTBI patients with ipsilateral tension SE after DC, which can eliminate SE as soon as possible, reduce the complications such as poor wound healing, improve the cerebrospinal fluid circulation and thus facilitate the patient’s recovery.

Craniocerebral trauma; Subdural effusion; Decompressive craniectomy; Long-term continuous drainage; Treatment outcome