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Evolution from Decompressive Craniectomy to Early Minimally Invasive Surgical Approach for Refractory Increased
Rudin Domi1, Filadelfo Coniglione2, Gentian Huti1
1University of Medicine, Tirana (UMT), Department Anaesthesiology and Intensive Care, Tirana, Albania.
Turkish Journal of Anaesthesiology and Reanimation
|July 24, 2025
Summary
Decompressive craniectomy (DC) is a critical surgical intervention for severe intracranial hypertension unresponsive to other treatments. This procedure aims to save lives and reduce neurological deficits when conventional therapies fail.
Area of Science:
- Neurosurgery
- Critical Care Medicine
- Neurology
Background:
- Elevated intracranial pressure (ICP) presents a significant clinical challenge in intensive care and emergency settings.
- Untreated intracranial hypertension can lead to severe outcomes, including brain edema, hypoxia, and mortality.
- Causes include traumatic brain injury, intracranial hemorrhage, and large ischemic strokes.
Purpose of the Study:
- To review current literature and summarize trends in the surgical management of intracranial hypertension.
- To highlight the role of decompressive craniectomy (DC) as a critical intervention.
Main Methods:
- Literature review summarizing published tendencies in surgical treatments for intracranial hypertension.
- Focus on the application and indications of decompressive craniectomy (DC).
Main Results:
- Decompressive craniectomy (DC) is an established surgical option for refractory intracranial hypertension.
- DC is indicated when conventional pharmacological and non-pharmacological therapies are ineffective.
- The procedure requires careful planning based on individual patient needs and clinical status.
Conclusions:
- Decompressive craniectomy (DC) is a life-saving intervention for severe intracranial hypertension.
- The decision for DC involves a comprehensive assessment of risks, benefits, and treatment alternatives.
- Surgical management, particularly DC, is increasingly recognized and utilized in neurocritical care.
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