Decompressive craniectomy in traumatic brain injury: Quo Vadis?

Abstract

Intracranial hypertension is the leading cause of mortality in patients with cranial injury. Currently the traumatic brain injury is a public health problem worldwide. Decompressive craniectomy emerges as a treatment strategy for patients with refractory intracranial hypertension. The completed surgery requires careful surgical technique and exquisite. We present a review of the literature about the technique.

Direct to Operating Room for Decompressive Craniotomy/Craniectomy in Patients With Traumatic Brain Injury

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QUALITY IMPROVEMENT

BACKGROUNDTrauma is a predominant cause of mortality in the United States; in 2019 alone, traumatic brain injuries (TBIs) accounted for nearly 61,000 deaths (Centers for Disease Control and Prevention [CDC], n.d.a). People of all ages and incomes are affected by TBI (Moscote-Salazar et al, 2013). Although many survive their TBI, patients are often afflicted by life-altering neurologic sequelae (CDC, 2015, n.d.b;Dixon, 2017).

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“…These deleterious consequences extend to their family members and society at large. Expeditious treatment of TBIs is associated with improved survival (Moscote-Salazar et al, 2013); therefore, optimal and prompt management has become a focus in contemporary trauma research. This is a retrospective cohort preintervention and postintervention study of severe traumatic brain injury patients undergoing decompressive craniectomy/craniotomy at a Midwestern U.S. Level I trauma center between 2016 and 2022.…”