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Postoperative Considerations Following Decompressive Hemicraniectomy

Jayde Nail1, John Herendeen1

  • 1Department of Neurosurgery, Tufts Medical Center, 800 Washington Street, Proger Building, 7th floor, Boston, MA 02111, USA.

Neurosurgery Clinics of North America
|April 12, 2026
PubMed

Decompressive hemicraniectomy is an important technique for relieving elevated intracranial pressure, usually caused by traumatic brain injury or cerebral edema after a large stroke. Patients face predictable risks during recovery, so neurosurgeons need to use effective prevention and management strategies. Hemorrhage on either side of the surgery should be monitored with computed tomographic scans. Herniation risk can be reduced with a properly sized craniectomy, and paradoxic herniation can be managed by patient positioning. Planning the incision to ensure good blood flow and sparing the superficial temporal artery helps prevent wound breakdown and infection.

Keywords:
Decompressive hemicraniectomyHydrocephalusSyndrome of the trephined

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