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Psychosurgery, the surgical alteration or permanent removal of brain tissue to alleviate severe psychological conditions, stands as one of the most radical and controversial treatments in the history of mental health care. Its development and application have evolved significantly, marked by dramatic shifts in scientific understanding and ethical perspectives.
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Updated: May 10, 2026

Microvascular Decompression: Salient Surgical Principles and Technical Nuances
10:35

Microvascular Decompression: Salient Surgical Principles and Technical Nuances

Published on: July 5, 2011

Decompressive craniectomy: past, present and future.

Angelos G Kolias1, Peter J Kirkpatrick, Peter J Hutchinson

  • 1Division of Neurosurgery, Department of Clinical Neurosciences, Addenbrooke's Hospital and University of Cambridge, Cambridge, CB2 0QQ, UK. angeloskolias@gmail.com

Nature Reviews. Neurology
|June 12, 2013
PubMed
Summary
This summary is machine-generated.

Decompressive craniectomy (DC) is controversial for brain swelling. While improving survival for stroke, it increases disability, raising ethical concerns and questioning its widespread use.

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Published on: August 5, 2014

Area of Science:

  • Neurosurgery
  • Neurology
  • Critical Care Medicine

Background:

  • Decompressive craniectomy (DC) is a surgical procedure to relieve intracranial pressure.
  • Its efficacy and role in managing brain edema and intracranial hypertension remain debated.
  • Contemporary practice guidelines for DC are evolving.

Observation:

  • Early DC for diffuse traumatic brain injury did not outperform medical management.
  • DC improves survival in malignant middle cerebral artery infarction but increases disability.
  • Ongoing trials assess secondary DC for refractory intracranial hypertension.

Findings:

  • The effectiveness of early DC in traumatic brain injury is questionable.
  • DC offers survival benefits for ischemic stroke but with significant disability risks.
  • Complications associated with DC and cranioplasty necessitate careful patient selection.

Implications:

  • The use of DC requires careful consideration of patient selection, surgical technique, and ethical implications.
  • Further clinical trials and cohort studies are crucial for optimizing DC outcomes.
  • Cost-effectiveness analyses are needed to guide resource allocation for DC procedures.