Evaluation of decompressive craniectomy in the management of traumatic brain injury : a series of 21 consecutive cases

Abstract EN

Background : Decompressive craniectomy has historically served as a salvage procedure to control intracranial pressure after severe traumatic brain injury.

Aim: to assess the safety and feasibility of decompressive craniectomy in the management of traumatic brain injury.

Patients and Methods : A prospective cross section study where 21 consecutive patients underwent emergent decompression for severe traumatic brain injury.

The patient presents with midline shift 3 mm or more and refractory ICP uncontrolled by medical treatment from January 2009 until December 2010.

Results: According to GOS, 14.3 % display complete recovery, 19% display moderate disability, 14.3 % displays sever disability, and 4.8 % display persistent vegetative state.

Surgery was done within 6 hours in 28.6% and after 6 hours in 71.4 % of cases.

ICP was significantly decreased intra and postoperative in comparison to preoperative value.

Conclusion: We concluded that decompressive craniectomy has a favorable outcome if it is performed early with wide craniectomy in less severely injured patients before the irreversible ischemic changes