Complications of Decompressive Craniectomy

Ho, Sandra; Ooi, Yinn Cher; Sheikh, Muhamad; Maltenfort, Mitchell; Jallo, Jack

doi:10.29046/jhnj.007.1.003

Cited by 2 publications

(1 citation statement)

References 21 publications

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“…4 However, decompressive hemicraniectomy itself has many complications. 5 As proven by the glymphatic system, cerebrospinal fluid (CSF) from the cisterns communicates with the brain parenchyma through the Virchow-Robin spaces (VRS). 6 Evacuation of the CSF by opening the basal subarachnoid cisterns is a well-recognized method for decreasing ICP.…”

Section: Introductionmentioning

confidence: 99%

Outcomes and Predictors of Outcome with Cisternostomy in the Management of Traumatic Brain Injury—A Prospective Observational Study at a Tertiary Centre

Vemula

Prasad

Banavath

et al. 2022

Indian Journal of Neurotrauma

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Background Traumatic brain injury (TBI) is a major cause of morbidity and mortality in young individuals. Goal of management in TBI patients is mainly focused on the secondary injury. Since the cisterns and the brain communicate, it would be possible to decrease the pressure in both these compartments by opening the cisterns to the atmospheric pressure. Objective To study the outcomes and predictors of outcome with cisternostomy in the management of TBI. Methods A single tertiary care center's prospective observational study of outcomes with cisternostomy with intraoperative intracranial pressure (ICP) monitoring. Patients were evaluated clinically and radiologically with Marshall CT score. They were categorized into mild, moderate, and severe head injury groups based on Glasgow coma scale (GCS) score. Outcomes were evaluated with Glasgow outcome scale (GOS) score. Results A total of 25 patients with TBI were enrolled in this study. They underwent cisternostomy with intraoperative ICP monitoring. They were categorized into 4 groups based on the age. In our study, mortality rate was 32%. As much as 48% had good recovery at 3 months follow-up with GOS 4 and 5. Mean ICP after cisternostomy was 6.36 ± 1.91 mm Hg. In our study, there was decrease in ICP after cisternostomy. Conclusion Age, time interval from trauma to surgery, and ICP showed prognostic importance on outcomes. Cisternostomy can efficiently decrease the ICP in the TBI patients and reduce postoperative complications.

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Section: Introductionmentioning

confidence: 99%