[Decompressive craniectomy and intracranial hypertension].

Area of Science:

• Neurosurgery
• Trauma Surgery
• Critical Care Medicine

Context:

• Refractory intracranial hypertension is a life-threatening condition following severe head injury.
• Decompressive craniectomy is a surgical intervention aimed at managing elevated intracranial pressure.
• Current evidence primarily consists of retrospective studies and case series.

Purpose:

• To review the current evidence on the efficacy of decompressive craniectomy in treating refractory intracranial hypertension after head injury.
• To evaluate the impact of decompressive craniectomy on mortality and functional outcomes in severe head trauma.
• To identify areas for future research, including prospective studies and comparative analyses.

Summary:

• Decompressive craniectomy has demonstrated a significant reduction in intracranial pressure in patients with severe head trauma.
• Studies indicate a decrease in mortality rates and an increase in favorable outcomes among survivors treated with this procedure.
• The review highlights the need for prospective validation of these findings and clearer guidelines for patient selection.

Impact:

• The findings suggest that decompressive craniectomy is a valuable treatment option for refractory intracranial hypertension, potentially improving survival and functional recovery.
• Further research is warranted to optimize the use of decompressive craniectomy and explore its role in conjunction with other therapeutic strategies.
• Clarifying indications and conducting comparative trials will enhance the evidence base for this critical neurosurgical intervention.