[Treatment of severe head injuries by external ventricular drainage and barbiturate therapy. Mortality and morbidity in 57 cases (author's transl)].

After severe head injury the majority of deaths, during the early period, is due to acute intracranial hypertension. We report a series of 57 severe head injuries with early signs of brainstem involvement. CT Scan performed within 6 hours after injury and repeated at 48 hours showed hemispheric lesions and edema, without shift of the middle line. Treatment consisted of controlled ventilation, water and sodium restriction and barbiturates. A ventricular catheter was inserted in 52 patients allowing intracranial pressure (I.C.P.) monitoring, and permanent subtraction of cerebrospinal fluid (C.S.F.). This treatment allowed the control of a normal I.C.P. in 80% of the patients. In 6 patients a secondary surgical treatment was performed. In this series the mortality rate was 31,5% the good results and moderate disability 54,3%, the severe disability and vegetatives states 14,2%.