Article Optimizing Traumatic Brain Injury Management: A Multidiscipl...

Decompressive craniectomy is a surgical procedure performed to alleviate refractory intracranial hypertension in patients with traumatic brain injury (TBI) or other intracranial pathologies. When medical management fails to adequately control intracranial pressure (ICP), decompressive craniectomy may be considered as a last resort to prevent secondary brain injury and improve outcomes. Here's how decompressive craniectomy plays a role in the management of refractory intracranial hypertension:

Decompressive craniectomy is typically reserved for patients with severe TBI who fail to respond to maximal medical management of intracranial hypertension. The decision to perform decompressive surgery requires careful consideration of the patient's clinical status, neurological prognosis, and potential risks and benefits. While decompressive craniectomy can be life-saving in certain cases, it is associated with complications such as infection, cerebral hypotension syndrome, and long-term neurocognitive deficits. Therefore, the decision to proceed with decompressive craniectomy should be made in consultation with a multidisciplinary team of neurosurgeons, intensivists, and neurologists, weighing the risks and benefits for each individual patient.