To investigate the clinical effect of standard large bone flap craniotomy for the treatment of double cerebral mydriasis in patients with severe traumatic brain injury (sTBI).

Seventy patients with bilateral mydriasis of sTBI induced terminal hernia admitted from July 2014 to July 2017 in our hospital were randomly divided into two groups. The control group (35 cases) underwent conventional craniotomy, and the observation group (35 cases) underwent standard craniotomy. Compare the two groups of short-term efficacy and postoperative complications.

The recovery rate in observation group was 31.43% at one month after operation, which was significantly higher than that in control group (8.57%, P<0.05). The proportion of severe disability was 11.43%, also significantly lower than the control group (34.29%, P<0.05). There was no significant difference in the proportions of light residue, plant survival and death between the two groups (P>0.05). The incidence of postoperative complications in the observation group was 34.29%, which was significantly lower than that in the control group (77.14%, P<0.01).

The application of standard large bone flap craniotomy in sTBI induced bilateral mydriasis may lead to significant results, which can effectively reduce postoperative complications and is worthy of clinical promotion.