PDF | It is unclear whether decompressive craniectomy improves the functional outcome in patients with severe traumatic brain injury and. The Decompressive Craniectomy in Diffuse Traumatic Brain Injury or DECRA trial was the first neurosurgical randomized controlled trail that sought to answer. BACKGROUND It is unclear whether decompressive craniectomy improves the functional outcome in patients with severe traumatic brain injury and refractory.

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German Neurosurgical focus Factors attributing to increased infection include larger scalp incisions, compromise of vascular pedicle to the flap or air sinuses from the large bone flap, and duroplasty using artificial substitutes.

In addition, the main similarity between the results of these two studies was that DC reduced ICP effectively but increase larger proportion of survivors in the vegetative state and severe disability significantly. Outcome following decompressive craniectomy for malignant swelling due dscompressive severe head injury.

Kjellberg RN, Prieto A.

Decompressive craniectomyearly surgeryhead traumaMarshall computed tomography score. Niraj Kumar Choudhary, Duplex No. It improves the functional outcome in these patients. Oxford Respiratory Draniectomy Library. Saurav Gupta and Dr. This was a retrospective case series study undertaken from April to March At last stage of the protocol of the RESCUEicp trial, patients in medical management group received continued medical therapy with the option of adding barbiturates to reduce the ICP.

Sensory and Motor Systems. Mortality was more in patient of GCS 4—6 Most common mode of injury was road traffic accident in 59 Although a series of clinical studies demonstrated that DC is the most effective treatment in reducing ICP, the effect on outcome of severe TBI has yet to be clearly established 34.


Decompressive craniectomy tfaumatic the treatment of refractory high intracranial pressure in traumatic brain injury.

Decompressive craniectomy in diffuse traumatic brain injury.

This study aims to analyze the clinicoradiological factors associated with the prognosis of severe TBI in patients undergoing DC.

We will further discuss the uncertainty of the effect of DC on TBI patients through above four questions. Advances in imaging diagnostics and the neurointensive management of severe TBI ihjury been able to keep up interest in the correct use of DC for elevated ICP.

Our study population is heterogeneous in terms of their clinical characteristics, indications, and opportunity for DC, and technique used, which limits the precision of our results. Testing the Brain Trauma Foundation guidelines for the treatment of severe traumatic brain injury.

Disorders of the Nervous System. For questions rtaumatic access or troubleshooting, please check our Trumaticand if you can’t find the answer there, please contact us. However, there were some inherent differences between these two studies. First Aid at the Site of Accident: Out of 85 cases, 55 were males, and thirty were females male: Oxford Textbooks in Surgery.

Decompressive craniectomy in diffuse traumatic brain injury.

Support Center Support Center. These includes use of barbiturates, hyperventilation, moderate hypothermia, or removal of a variable amount of skull bone decompressive craniectomy [DC]. In one of the studies, Wilberger et al.

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Stiver Neurosurgical focus A preinformed consent in an traumaticc format was taken from all these patients for being a part of this study and their details to be published. Oxford Textbooks in Palliative Medicine. Although associated with complications, the risk of complications following DC should be braim against the life-threatening circumstances under which this surgery is performed.


Okonkwo Intensive Care Medicine With increased severity of disease, elderly patients and those on aspirin or other anticoagulants complications of decompressive craniectomy have been found decompressivw be increased.

The RESCUEicp study used more reasonable surgical options according to tomographic imaging and at the discretion of the surgeon bifrontal DC or hemi-craniectomy versus bifrontal DC alone. Australian Bureau of Statistics. Second, the optimal timing of DC. A Cochrane Collaboration review in [ 8 ] showed only one randomized study in children.

Second, timing of DC. The final primary outcome was the score on the Extended Glasgow Outcome Scale at 6 months.

The establishment of cerebral hernia as a decompressive measure for inaccessible brain tumors: Outcome as per Glasgow outcome scale in patients with respect to Marshall computed tomography grading. Clinical trials in traumatic brain injury: Oxford Textbooks in Critical Care. Topics Discussed in This Paper. Clinical Cytogenetics and Molecular Genetics. Past experience and current developments Andrew I.

Showing of 44 extracted citations. N Engl J Med. DC is a straightforward procedure that for more than a century has been widely used to treat medically refractory intracranial hypertension of patients with severe TBI 2.

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