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Intraoperative Management During Decompressive Craniectomy.

Susan Yoo¹, Sherry Liou¹

¹Department of Anesthesia, Zuckerberg San Francisco General Hospital, University of California San Francisco, 1001 Potrero Avenue, Building 5, 3C, San Francisco, CA 94110, USA.

Neurosurgery Clinics of North America

|April 12, 2026

Summary

This summary is machine-generated.

Managing patients undergoing decompressive craniectomy requires specific perioperative goals to prevent secondary brain injury. This review outlines key intraoperative management strategies and considerations for improved patient outcomes.

Keywords:

Anesthesia cerebral physiology Decompressive craniectomy Hemodynamic goals Intraoperative management

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Area of Science:

Neurosurgery
Anesthesiology
Critical Care Medicine

Background:

Decompressive craniectomy is a critical neurosurgical procedure to manage elevated intracranial pressure.
Preventing secondary brain injury is paramount for patient outcomes.

Purpose of the Study:

To review intraoperative management goals for decompressive craniectomy.
To highlight unique perioperative considerations for this patient population.

Main Methods:

Review of intraoperative management strategies.
Discussion of preoperative evaluation.
Analysis of anesthesia induction and maintenance.
Examination of fluid balance and transfusion goals.

Main Results:

Standard goals include maintaining oxygenation, perfusion, and hemodynamic stability.
Physiologic goals are specific to patients undergoing decompressive craniectomy.
Comprehensive perioperative management is essential.

Conclusions:

Optimizing perioperative care is crucial for reducing secondary brain injury.
Specific anesthetic and fluid management strategies are vital.
This review provides a framework for managing patients undergoing decompressive craniectomy.