Related Experiment Video
Updated: Nov 16, 2025
02:30
Endoscopic Approach for Colloid Cyst Resection
Published on: May 23, 2025
397
Extra-Axial Fluid Collections After Decompressive Craniectomy: Management, Outcomes, and Treatment Algorithm
Aislyn C DiRisio1, Brittany M Stopa2, Yuri A Pompeu3
1Computational Neuroscience Outcomes Center, Department of Neurosurgery, Harvard Medical School, Boston, Massachusetts, USA; Icahn School of Medicine at Mount Sinai, New York, New York, USA.
World Neurosurgery
|February 27, 2021
Summary
Extra-axial fluid collections (EACs) after decompressive craniectomy resolve faster with early bone flap restoration and drainage. This study identifies EAC phenotypes and proposes a treatment algorithm for better patient outcomes.
Area of Science:
- Neurosurgery
- Critical Care Medicine
- Neurology
Background:
- Extra-axial fluid collections (EACs) are common post-decompressive craniectomy.
- Management and prediction of EAC clinical course require further understanding.
- This study aims to characterize EACs and identify optimal treatment strategies.
Purpose of the Study:
- To characterize extra-axial fluid collections (EACs) post-decompressive craniectomy.
- To identify predictors of EAC resolution.
- To delineate an effective treatment paradigm for EACs.
Main Methods:
- Retrospective review of 96 patients with EACs post-decompressive craniectomy.
- Exclusion of patients with ischemic stroke-related EACs.
- Univariate analysis, multiple linear regression, and systematic literature review.
Main Results:
- EACs resolved in a median of 60 days; 62.5% were complicated.
- Complicated EACs did not correlate with prolonged course or increased mortality.
- Early bone flap restoration with simultaneous drainage predicted faster EAC resolution (P < 0.001).
Conclusions:
- Two distinct EAC phenotypes (complicated and uncomplicated) were identified.
- A treatment algorithm involving early bone flap replacement and aggressive drainage is proposed.
- Further research on long-term outcomes of EACs is necessary.
