Complications of decompressive craniectomy for traumatic brain injury

被引:268
|
作者
Stiver, Shirley I. [1 ,2 ]
机构
[1] Univ Calif San Francisco, Sch Med, Dept Neurosurg Surg, San Francisco, CA 94143 USA
[2] Univ Calif San Francisco, Brain & Spinal Injury Ctr, San Francisco, CA 94143 USA
关键词
traumatic brain injury; intracranial hypertension; surgical decompression; cranioplasty; complication; trephine; REFRACTORY INTRACRANIAL HYPERTENSION; ACUTE SUBDURAL-HEMATOMA; SEVERE HEAD-INJURIES; ACUTE EPIDURAL HEMATOMA; CEREBRAL-BLOOD-FLOW; SURGICAL DECOMPRESSION; PARADOXICAL HERNIATION; PERFUSION-PRESSURE; FLUID DRAINAGE; SKULL DEFECTS;
D O I
10.3171/2009.4.FOCUS0965
中图分类号
R74 [神经病学与精神病学];
学科分类号
摘要
Decompressive craniectomy is widely used to treat intracranial hypertension following traumatic brain injury (TBI). Two randomized trials are currently underway to further evaluate the effectiveness of decompressive craniectomy for TBI. Complications of this procedure have major ramifications on the risk-benefit balance in decision-making during evaluation of potential surgical candidates. To further evaluate the complications of decompressive craniectomy, a review of the literature was performed following a detailed search of PubMed between 1980 and 2009. The author restricted her study to literature pertaining to decompressive craniectomy for patients with TBI. An understanding of the pathophysiological events that accompany removal of a large piece of skull bone provides a foundation for understanding many of the complications associated with decompressive craniectomy. The author determined that decompressive craniectomy is not a simple, straightforward operation without adverse effects. Rather, numerous complications may arise, and they do so in a sequential fashion at specific time points following surgical decompression. Expansion of contusions, new subdural and epidural hematomas contralateral to the decompressed hemisphere, and external cerebral herniation typify the early perioperative complications of decompressive craniectomy for TBI. Within the 1st week following decompression, CSF circulation derangements manifest commonly as subdural hygromas. Paradoxical herniation following lumbar puncture in the setting of a large skull defect is a rare, potentially fatal complication that can be prevented and treated if recognized early. During the later phases of recovery, patients may develop a new cognitive, neurological, or psychological deficit termed syndrome of the trephined. In the longer term, a persistent vegetative state is the most devastating of outcomes of decompressive craniectomy. The risk of complications following decompressive craniectomy is weighed against the life-threatening circumstances under which this surgery is performed. Ongoing trials will define whether this balance supports surgical decompression as a first-line treatment for TBI. (DOI: 10.3171/2009.4.FOCUS0965)
引用
收藏
页码:1 / 16
页数:16
相关论文
共 50 条
  • [1] Analysis of Complications Following Decompressive Craniectomy for Traumatic Brain Injury
    Ban, Seung Pil
    Son, Young-Je
    Yang, Hee-Jin
    Chung, Yeong Seob
    Lee, Sang Hyung
    Han, Dae Hee
    [J]. JOURNAL OF KOREAN NEUROSURGICAL SOCIETY, 2010, 48 (03) : 244 - 250
  • [2] Complications of cranioplasty after decompressive craniectomy for traumatic brain injury
    Chaturvedi, Jitender
    Botta, Ragasudha
    Prabhuraj, A. R.
    Shukla, Dhaval
    Bhat, Dahnanjay I.
    Devi, B. Indira
    [J]. BRITISH JOURNAL OF NEUROSURGERY, 2016, 30 (02) : 264 - 268
  • [3] Decompressive Craniectomy for Traumatic Brain Injury
    Hutchinson, Peter
    [J]. CANADIAN JOURNAL OF NEUROLOGICAL SCIENCES, 2011, 38 (04) : 541 - 542
  • [4] DECOMPRESSIVE CRANIECTOMY FOR TRAUMATIC BRAIN INJURY
    Prusty, Gouri K.
    Chattopadhyay, M.
    [J]. JOURNAL OF NEUROTRAUMA, 2011, 28 (05) : A23 - A23
  • [5] Decompressive Craniectomy in Diffuse Traumatic Brain Injury
    Cooper, D. James
    Rosenfeld, Jeffrey V.
    Murray, Lynnette
    Arabi, Yaseen M.
    Davies, Andrew R.
    D'Urso, Paul
    Kossmann, Thomas
    Ponsford, Jennie
    Seppelt, Ian
    Reilly, Peter
    Wolfe, Rory
    [J]. NEW ENGLAND JOURNAL OF MEDICINE, 2011, 364 (16): : 1493 - 1502
  • [6] The Role of Decompressive Craniectomy in Traumatic Brain Injury
    Mencl, Libor
    Callo, Andrej
    Girsa, David
    Waldauf, Petr
    Vyhnanek, Frantisek
    Haninec, Pavel
    [J]. BRAIN INJURY, 2019, 33 : 243 - 243
  • [7] Severe traumatic brain injury and decompressive craniectomy
    Adelson, P. David
    [J]. JOURNAL OF NEUROSURGERY-PEDIATRICS, 2015, 16 (05) : 505 - 506
  • [8] Decompressive craniectomy in diffuse traumatic brain injury
    Marion, Donald W.
    [J]. LANCET NEUROLOGY, 2011, 10 (06): : 497 - 498
  • [9] Indication of Decompressive Craniectomy in Traumatic Brain Injury
    Juran, V.
    Smrcka, M.
    Svoboda, K.
    Fadrus, P.
    Sprlakova, A.
    Gal, R.
    [J]. CESKA A SLOVENSKA NEUROLOGIE A NEUROCHIRURGIE, 2009, 72 (05) : 439 - 445
  • [10] The History of Decompressive Craniectomy in Traumatic Brain Injury
    Rossini, Zefferino
    Nicolosi, Federico
    Kolias, Angelos G.
    Hutchinson, Peter J.
    De Sanctis, Paolo
    Servadei, Franco
    [J]. FRONTIERS IN NEUROLOGY, 2019, 10