scholarly journals A Survey about Surgical Preferences in Operative Technique in Decompressive Craniectomy in Traumatic Brain Injury

2013 ◽  
Vol 2 (3) ◽  
pp. 106-111
Author(s):  
Andres M Rubiano ◽  
Hernando Raphael Alvis-Miranda ◽  
Gabriel Alcalá-Cerra ◽  
Luis Rafael Moscote-Salazar
Keyword(s):  
Public Health ◽  
Traumatic Brain Injury ◽  
Critical Care ◽  
Brain Injury ◽  
Intracranial Hypertension ◽  
Decompressive Craniectomy ◽  
Health Problem ◽  
Operative Technique ◽  
Public Health Problem ◽  
Neurosurgical Procedure

ABSTRACT Traumatic brain injury is a public health problem. The control of intracranial hypertension is a key strategy for managing this type of patients. Decompressive craniectomy is a measure of second level for the control of intracranial hypertension refractory to medical management. In order to assess trends in relationship to the management of decompressive craniectomy, a survey was designed and sent to neurosurgeons from various countries. We discuss the results for a better standardization of surgical techinique. Decompressive craniectomy is a saving technique and usefulness depend on a correct realization of the neurosurgical procedure. How to cite this article Alvis-Miranda HR, Alcala-Cerra G, Rubiano AM, Moscote-Salazar LR. A Survey about Surgical Preferences in Operative Technique in Decompressive Craniectomy in Traumatic Brain Injury. J Trauma Critical Care Emerg Surg 2013;2(3):106-111.

Intraoperative blood loss during decompressive craniectomy for intractable intracranial hypertension after severe traumatic brain injury in children

2014 ◽  
Vol 30 (8) ◽  
pp. 1393-1398 ◽  
Author(s):  
François-Pierrick Desgranges ◽  
Etienne Javouhey ◽  
Carmine Mottolese ◽  
Anne Migeon ◽  
Alexandru Szathmari ◽  
...  
Keyword(s):  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Blood Loss ◽  
Intracranial Hypertension ◽  
Decompressive Craniectomy ◽  
Severe Traumatic Brain Injury ◽  
Intraoperative Blood Loss

scholarly journals Study of the Long-Term Results of Decompressive Craniectomy after Severe Traumatic Brain Injury Based on a Series of 60 Consecutive Cases

2014 ◽  
Vol 2014 ◽  
pp. 1-10 ◽  
Author(s):  
Gaétane Gouello ◽  
Olivier Hamel ◽  
Karim Asehnoune ◽  
Eric Bord ◽  
Roger Robert ◽  
...  
Keyword(s):  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Intracranial Hypertension ◽  
Decompressive Craniectomy ◽  
Severe Traumatic Brain Injury ◽  
Favourable Outcome ◽  
Long Term Results ◽  
Term Outcome ◽  
Long Term Outcome

Background. Decompressive craniectomy can be proposed in the management of severe traumatic brain injury. Current studies report mixed results, preventing any clear conclusions on the place of decompressive craniectomy in traumatology.Methods. The objective of this retrospective study was to evaluate the results of all decompressive craniectomies performed between 2005 and 2011 for refractory intracranial hypertension after severe traumatic brain injury. Sixty patients were included. Clinical parameters (Glasgow scale, pupillary examination) and radiological findings (Marshall CT scale) were analysed. Complications, clinical outcome, and early and long-term Glasgow Outcome Scale (GOS) were evaluated after surgery. Finally, the predictive value of preoperative parameters to guide the clinician’s decision to perform craniectomy was studied.Results. Craniectomy was unilateral in 58 cases and the mean bone flap area was 100 cm2. Surgical complications were observed in 6.7% of cases. Mean followup was 30 months and a favourable outcome was obtained in 50% of cases. The initial Glasgow Scale was the only statistically significant predictive factor for long-term outcome.Conclusion. Despite the discordant results in the literature, this study demonstrates that decompressive craniectomy is useful for the management of refractory intracranial hypertension after severe traumatic brain injury.

scholarly journals Critical Care Management of Traumatic Brain Injury

2019 ◽  
Vol 06 (03) ◽  
pp. 187-199
Author(s):  
Suparna Bharadwaj ◽  
Shweta Naik
Keyword(s):  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Head Injury ◽  
Health Problem ◽  
Care Management ◽  
Cerebral Oxygenation ◽  
Care Center ◽  
Public Health Problem ◽  
Major Health Problem ◽  
Brain Trauma Foundation

AbstractTraumatic brain injury (TBI) is a significant public health problem. It is the leading cause of death and disability despite advancements in its prevention and treatment. Treatment of a patient with head injury begins on the site of trauma and continues even during her/his transportation to the trauma care center. Knowledge of secondary brain injuries and timely management of those in the prehospital period can significantly improve the outcome and decrease mortality after TBI. Intensive care management of TBI is guided by Brain Trauma Foundation guidelines (4th edition). Seventy percent of blunt trauma patients will also suffer from some degree of head injury. The management of these extracranial injuries may influence the neurological outcomes. Damage control tactics may improve early mortality (control hemorrhage) and delayed mortality (minimize systemic inflammation and organ failure). Neuromonitoring plays an important role in the management of TBI because it is able to assess multiple aspects of cerebral physiology and guide therapeutic interventions intended to prevent or minimize secondary injury. Bedsides, multimodality monitoring predominantly comprises monitoring modalities for cerebral blood flow, cerebral oxygenation, and cerebral electrical activity. Establishing a reliable prognosis early after injury is notoriously difficult. However, TBI is a much more manageable injury today than it has been in the past, but it remains a major health problem.

scholarly journals Decompressive craniectomy of post-traumatic brain injury: an in silico modelling approach for intracranial hypertension management

2020 ◽  
Vol 10 (1) ◽  
Author(s):  
Chryso Lambride ◽  
Nicolas Christodoulou ◽  
Anna Michail ◽  
Vasileios Vavourakis ◽  
Triantafyllos Stylianopoulos
Keyword(s):  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Intracranial Pressure ◽  
Intracranial Hypertension ◽  
Brain Tissue ◽  
Decompressive Craniectomy ◽  
In Silico ◽  
Pressure Loading ◽  
Post Traumatic ◽  
The Brain

Abstract Traumatic brain injury (TBI) causes brain edema that induces increased intracranial pressure and decreased cerebral perfusion. Decompressive craniectomy has been recommended as a surgical procedure for the management of swollen brain and intracranial hypertension. Proper location and size of a decompressive craniectomy, however, remain controversial and no clinical guidelines are available. Mathematical and computational (in silico) models can predict the optimum geometric conditions and provide insights for the brain mechanical response following a decompressive craniectomy. In this work, we present a finite element model of post-traumatic brain injury and decompressive craniectomy that incorporates a biphasic, nonlinear biomechanical model of the brain. A homogenous pressure is applied in the brain to represent the intracranial pressure loading caused by the tissue swelling and the models calculate the deformations and stresses in the brain as well as the herniated volume of the brain tissue that exits the skull following craniectomy. Simulations for different craniectomy geometries (unilateral, bifrontal and bifrontal with midline bar) and sizes are employed to identify optimal clinical conditions of decompressive craniectomy. The reported results for the herniated volume of the brain tissue as a function of the intracranial pressure loading under a specific geometry and size of craniectomy are exceptionally relevant for decompressive craniectomy planning.

A randomized trial of very early decompressive craniectomy in children with traumatic brain injury and sustained intracranial hypertension

2001 ◽  
Vol 17 (3) ◽  
pp. 154-162 ◽  
Author(s):  
Anna Taylor ◽  
Warwick Butt ◽  
Jeffrey Rosenfeld ◽  
Frank Shann ◽  
Michael Ditchfield ◽  
...  
Keyword(s):  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Randomized Trial ◽  
Intracranial Hypertension ◽  
Decompressive Craniectomy
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