Related Experiment Video
Updated: May 29, 2026
A Pediatric Concussion Model in Mice: Closed Head Injury with Long-Term Disorders (CHILD)
Published on: February 7, 2025
Decompressive hemicraniectomy for pediatric traumatic brain injury: long-term outcome based on quality of life
Arun T Jacob1, Gregory G Heuer, Ryan Grant
1Department of Neurosurgery, University of Pennsylvania Health System, Philadelphia, PA 19104, USA. arun.jacob@uphs.upenn.edu
Insights
Decompressive hemicraniectomy (DCH) in pediatric brain injury patients leads to favorable outcomes in most cases. This procedure improves quality of life for survivors, demonstrating its effectiveness in managing severe head trauma.
Area of Science:
- Neurosurgery
- Pediatric Neurology
- Critical Care Medicine
Background:
- Decompressive hemicraniectomy (DCH) is a neurosurgical procedure used to reduce intracranial pressure.
- The long-term impact of DCH on pediatric patients with brain injuries requires further investigation.
- Assessing quality of life outcomes is crucial for evaluating the success of DCH in children.
Purpose of the Study:
- To systematically review and analyze patient outcomes, including quality of life, following DCH in pediatric populations.
- To determine the overall effectiveness of DCH in improving the prognosis of pediatric brain injury.
- To consolidate existing literature with institutional data for a comprehensive analysis.
Main Methods:
- A systematic literature review was conducted, identifying 17 relevant articles.
- Institutional data from 13 pediatric patients undergoing DCH between 2000 and 2008 were included.
- Pooled analysis of 186 pediatric DCH cases was performed to assess outcomes.
Main Results:
- The pooled 6-month mortality rate following DCH in pediatric patients was 21.1%.
- A significant majority of survivors (112 out of 186 cases) achieved favorable outcomes (Glasgow Outcome Scale scores of 4-5).
- The average pooled quality of life score among survivors was 0.75, indicating a functional outcome between moderate disability and good recovery.
Conclusions:
- Decompressive hemicraniectomy is associated with a majority of favorable outcomes in pediatric patients with severe brain injuries.
- The procedure demonstrates a positive impact on the quality of life for pediatric survivors.
- DCH is a viable treatment option for intractable intracranial pressure in children, leading to improved neurological recovery.
Aims:
The impact of decompressive hemicraniectomy (DCH) on the overall outcome of pediatric brain injury patients has not been fully determined. In this paper, the authors performed a systematic review of patient outcome based on quality of life following DCH in a pediatric population.
Methods:
We describe our experience with decompressive craniectomy in pediatric patients and perform a literature review and pooled outcomes analysis to supplement these findings. A total of 13 children underwent DCH for intractable intracranial pressure in our institution from 2000 to 2008. Follow-up was available in 11 patients with 1 death (9%) and 7 survivors (70%) obtaining a favorable outcome (Glasgow Outcome Scale, GOS, scores = 4-5).
Results:
A literature review to determine the usefulness of DCH identified 17 articles that, when combined with our series, resulted in 186 pediatric DCH cases. Pooled outcomes found 42 deaths and 112 patients who had favorable outcomes at 6 months. The average 6-month mortality was 21.1%, and the pooled mean quality of life among survivors 0.75 (0.68-0.82), midway between moderate disability and good outcome.
Conclusions:
Based on our findings, DCH results in a majority of pediatric patients having a good outcome based on the GOS score.
