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Complications of decompressive craniectomy for head injury

S Honeybul1

  • 1Department of Neurosurgery, Sir Charles Gairdner Hospital and Royal Perth Hospital, Hospital Avenue, Nedlands, Western Australia 6009, Australia. stephen.honeybul@health.wa.gov.au

Journal of Clinical Neuroscience : Official Journal of the Neurosurgical Society of Australasia
|February 26, 2010
PubMed

Insights

Decompressive craniectomy for severe head injury has significant complications, including cortical herniation and subdural effusions. Subsequent cranioplasty can lead to infection and bone flap resorption, with rare fatal outcomes.

Area of Science:

  • Neurosurgery
  • Trauma Surgery

Background:

  • Decompressive craniectomy is a neurosurgical procedure to manage intracranial hypertension.
  • The procedure, while technically feasible, carries a risk of substantial complications.

Purpose of the Study:

  • To analyze complications associated with decompressive craniectomy and subsequent cranioplasty.
  • To differentiate complications of the surgical procedure from consequences of the primary traumatic brain injury.

Main Methods:

  • Retrospective analysis of 41 patients undergoing decompressive craniectomy for severe head injury.
  • Data collected from Sir Charles Gairdner Hospital and Royal Perth Hospital between 2006-2007.

Main Results:

  • High rates of complications from decompressive surgery: cortical herniation (51%), subdural effusion (62%).
  • Cranioplasty complications included infection (11%) and bone flap resorption (17%), leading to Syndrome of the Trephined in 7%.
  • Two deaths (5.5%) were directly attributed to the surgical procedures.

Conclusions:

  • Decompressive craniectomy and cranioplasty are associated with significant morbidity and mortality.
  • Careful patient selection and surgical technique are crucial to mitigate risks.
  • Further research is needed to refine management strategies and improve outcomes.

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