Monitoring and Intraoperative Management of Elevated Intracranial Pressure and Decompressive Craniectomy

2007 ◽  
Vol 25 (3) ◽  
pp. 579-603 ◽  
Author(s):  
W. Andrew Kofke ◽  
Michael Stiefel
Keyword(s):  
Intracranial Pressure ◽  
Decompressive Craniectomy ◽  
Elevated Intracranial Pressure ◽  
Intraoperative Management

Trauma: Traumatic Brain Injury

2018 ◽  
pp. 95-100
Author(s):  
Ruchir Gupta
Keyword(s):  
Traumatic Brain Injury ◽  
Substance Abuse ◽  
Acute Respiratory Distress Syndrome ◽  
Cervical Spine ◽  
Brain Injury ◽  
Intracranial Pressure ◽  
Glasgow Coma Scale ◽  
Elevated Intracranial Pressure ◽  
Intraoperative Management ◽  
History Of

In this chapter the essential aspects of anesthesia for traumatic brain injury are discussed. Subtopics include manifestations and treatment of elevated intracranial pressure (ICP), Glasgow Coma Scale (GCS), drugs used to lower ICP, and patient monitoring. The case presented is an emergent craniotomy. The chapter is divided into preoperative, intraoperative, and postoperative sections with important subtopics related to the main topic in each section. Preoperative topics discussed are evaluation of trauma, use of the GCS in this case, assessing intracranial hypertension, history of substance abuse, and clearing the cervical spine. Issues related to intraoperative management in this case include induction and use of blood products. Postoperative concerns addressed include polyuria and acute respiratory distress syndrome.

Decompressive craniectomy in pediatric patients with traumatic brain injury with intractable elevated intracranial pressure

2006 ◽  
Vol 41 (1) ◽  
pp. 83-87 ◽  
Author(s):  
Daniel Rutigliano ◽  
Michael R. Egnor ◽  
Cedric J. Priebe ◽  
Jane E. McCormack ◽  
Nancy Strong ◽  
...  
Keyword(s):  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Intracranial Pressure ◽  
Decompressive Craniectomy ◽  
Pediatric Patients ◽  
Elevated Intracranial Pressure

Optimal timing of autologous cranioplasty after decompressive craniectomy in children

2012 ◽  
Vol 10 (4) ◽  
pp. 268-272 ◽  
Author(s):  
Mark P. Piedra ◽  
Eric M. Thompson ◽  
Nathan R. Selden ◽  
Brian T. Ragel ◽  
Daniel J. Guillaume
Keyword(s):  
Intracranial Pressure ◽  
Bone Resorption ◽  
Decompressive Craniectomy ◽  
Pediatric Patients ◽  
Optimal Timing ◽  
Raised Intracranial Pressure ◽  
Elevated Intracranial Pressure ◽  
Children's Hospital ◽  
Children’S Hospital ◽  
Early Cranioplasty

Object The object of this study was to determine if early cranioplasty after decompressive craniectomy for elevated intracranial pressure in children reduces complications. Methods Sixty-one consecutive cases involving pediatric patients who underwent autologous cranioplasty after decompressive craniectomy for raised intracranial pressure at a single academic children's hospital over 15 years were studied retrospectively. Results Sixty-one patients were divided into early (< 6 weeks; 28 patients) and late (≥ 6 weeks; 33 patients) cranioplasty cohorts. The cohorts were similar except for slightly lower age in the early (8.03 years) than the late (10.8 years) cranioplasty cohort (p < 0.05). Bone resorption after cranioplasty was significantly more common in the late (42%) than the early (14%) cranioplasty cohort (p < 0.05; OR 5.4). No other complication differed in incidence between the cohorts. Conclusions After decompressive craniectomy for raised intracranial pressure in children, early (< 6 weeks) cranioplasty reduces the occurrence of reoperation for bone resorption, without altering the incidence of other complications.

scholarly journals Introduction: Decompressive craniectomy for trauma and cerebrovascular disease

2009 ◽  
Vol 26 (6) ◽  
pp. E1 ◽  
Author(s):  
Geoffrey T. Manley
Keyword(s):  
Intracranial Pressure ◽  
Decompressive Craniectomy ◽  
Causes Of Death ◽  
Timing Of Surgery ◽  
Elevated Intracranial Pressure ◽  
Medical Treatments ◽  
Cerebral Herniation ◽  
Common Causes ◽  
The Face ◽  
Surgical Option

Elevated intracranial pressure is one of the most common causes of death and disability following severe traumatic brain injury and ischemic stroke. Unfortunately, there have been no new medical treatments for cerebral edema and elevated intracranial pressure in more than 80 years. Decompressive craniectomy may be an appropriate surgical option in the face of elevated intracranial pressure that is refractory to medical treatment. When performed correctly, this procedure can reduce intracranial pressure and prevent cerebral herniation and death. The last decade has seen a renewed interest in the use of decompressive craniectomy, but many questions remain regarding patient selection, timing of surgery, surgical technique, timing of cranioplasty, and complications.

Open-wound treatment for gunshot to the brain

2012 ◽  
Vol 10 (1) ◽  
pp. 64-66 ◽  
Author(s):  
Pepijn van den Munckhof ◽  
Vincent G. Geukers ◽  
Fonnet E. Bleeker ◽  
Celia E. Allison ◽  
W. Peter Vandertop
Keyword(s):  
Intracranial Pressure ◽  
Decompressive Craniectomy ◽  
Gunshot Wound ◽  
Wound Treatment ◽  
Elevated Intracranial Pressure ◽  
Open Wound ◽  
Functional Level ◽  
Open Wound Treatment ◽  
The Brain

The authors report a case of a gunshot wound to the brain in a 2.5-year-old girl. To treat the uncontrollably elevated intracranial pressure, the patient underwent bilateral decompressive craniectomy and experimental open-wound treatment. She recovered to a good functional level.

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