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Microvascular Decompression: Salient Surgical Principles and Technical Nuances
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Decompressive Craniectomy in Neurocritical Care.

Erik G Hayman1, David B Kurland1, Zachary Grunwald2

  • 1Departments of Neurosurgery, University of Maryland School of Medicine, Baltimore, Maryland.

Seminars in Neurology
|December 2, 2016
PubMed
Summary

Decompressive craniectomy (DC) is a vital neurocritical care procedure. This review details DC indications, including stroke and TBI, and its unique complications for neurointensivists.

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Area of Science:

  • Neurosurgery
  • Neurocritical Care
  • Neurology

Background:

  • Decompressive craniectomy (DC) is increasingly utilized in neurocritical care settings.
  • This review targets neurointensivists, providing a comprehensive overview of DC.

Purpose of the Study:

  • To summarize the procedure, indications, and complications of decompressive craniectomy.
  • To offer guidance on managing DC-related complications.

Main Methods:

  • Literature review of established and lesser-known indications for DC.
  • Review of complications associated with DC and their management.

Main Results:

  • Established indications include infarction and traumatic brain injury.

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  • Lesser-known indications encompass intracerebral hemorrhage, ruptured cerebrovascular malformations, sinus thrombosis, and infection.
  • Complications such as syndrome of the trephined, hygroma, and hydrocephalus are discussed.

    • Conclusions:

    • Decompressive craniectomy is a critical intervention with diverse applications in neurocritical care.
    • Understanding and managing DC-specific complications is essential for optimal patient outcomes.