To explore the efficacy and advantages of unilateral and bilateral different craniotomies in the treatment of patients with asymmetric bilateral frontal contusion.

The clinical data of patients with asymmetric bilateral frontal contusion treated from February 2016 to February 2019 in Neurosurgery Department of the 900^th Hospital of Joint Logistics Team were retrospectively analyzed. They were divided into unilateral frontotemporal craniotomy combined with falx cerebral incision group and bilateral coronary craniotomy group according to different surgical approaches. The gender, age, preoperative GCS score, operation time, intraoperative amount of bleeding, postoperative, incidence of intracranial infection, GOS score and frontal assessment battery (FAB) scale at 3 months were analyzed.

Forty-three patients were enrolled, including 18 cases with unilateral frontotemporal craniotomy, and 25 cases with bilateral coronary craniotomy. Baseline data were compared between the 2 groups with no significant difference (P>0.05). The operative time and intraoperative blood loss of unilateral group were less than those of bilateral group, and the difference was statistically significant (P<0.05). The FAB scores at 3 months in unilateral group were higher than those in bilateral group, the difference was statistically significant (P<0.05). There were no significant differences in postoperative intracranial infection and GOS score at 3 months between the two groups (P>0.05).

Unilateral frontotemporal craniotomy combined with falx cerebral incision not only has surgical efficacy consistent with bilateral coronary craniotomy, but also has the advantages of less trauma, shorter operation time, better protection of frontal function.