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All Abstracts

Surgery to remove clots from the brain are associated with poorer outcome for those with very severe and mild traumatic brain injuries.

Categories: Medical Consequences

The Question

Do people who have surgery to remove a clot from the brain after a traumatic brain injury have a less favorable long-term recovery than those who do not need that surgery?

Past Studies

Past Studies found that older people who required surgery for removal of a blood clot did not generally fare as well as those people who did not require surgery. Others found, however that controlling the pressure within the brain was actually more critical in determining outcomes. 

This Study

This Study included 341 people who were admitted to a hospital after sustaining a traumatic brain injury. One hundred and thirteen people who required one or more surgeries to remove a clot were compared with 232 people required no surgery. Each person’s recovery was assessed using the Disability Rating Scale, which is sensitive to long-term recovery changes. The researchers found that people with moderate brain injury fared about as well whether they required surgery or not. People with mild and severe brain injury who required surgery did not do as well as those with mild and severe injury who did not require surgery. People who required more than one surgery for clot removal did better than those who only required one surgery, but not as well as those who did not require any surgery. It is possible that those with moderate brain injury did equally well whether they required surgery or not because people in these groups sustained about the same amount of damage whether it was due to clot formation or more diffuse damage to the brain tissue.

Who is Affected by this Study

People with brain injury who underwent one or more surgeries for the removal of blood clots on the brain.


The study group had an unusually large percentage of people who were injured as the result of violence. In addition, educational levels, racial balance and employment status were not representative of the whole population of persons with brain injury.

Bottom Line

Mild and severe brain injury that requires surgery for clot removal is more likely to result in poorer outcomes.

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Find This Study


Zafonte, Ross; Ricker, Joseph; Lombard, Lisa; Mann, Nancy; and Black, Kertia. “Does the requirement of a craniotomy predict outcome ?: a preliminary investigation”. Brain Injury. Vol. 13, no. 1, pp. 31-38.