The place of decompressive surgery in the treatment of uncontrollable post-traumatic intracranial hypertension in children.
The authors report two cases of post-traumatic uncontrollable intracranial hypertension in children (120 torr in case 1; 90 torr in case 2) who were treated within the first 12 h after trauma by surgery including decompressive craniectomy. The outcome was favourable in both children. Intracranial pressure (ICP) was recorded during the pre-, intra- and postoperative periods and during each specific step of the surgical procedure. Craniectomy alone induced a decrease in ICP of 45% (40 torr) in case 1 and 30% (35 torr) in case 2. Although this method remains controversial, given the lack of controlled trials, it can offer a salvage procedure in children with rapidly worsening intracranial hypertension, allowing survival without disabling neurological sequelae.
Dam Hieu
P
P
Department of Neurosurgery, Centre Hospitalier et Universitaire A. Morvan, Brest, France.
Sizun
J
J
Person
H
H
Besson
G
G
D001924:Brain Concussion / Q000000981:diagnostic imaging / Q000601:surgery*; D001929:Brain Edema / Q000000981:diagnostic imaging / Q000601:surgery; D002540:Cerebral Cortex / Q000000981:diagnostic imaging / Q000293:injuries / Q000601:surgery; D002543:Cerebral Hemorrhage / Q000000981:diagnostic imaging / Q000601:surgery; D002648:Child; D003399:Craniotomy / Q000379:methods*; D019299:Decompression, Surgical / Q000379:methods*; D005260:Female; D006801:Humans; D007427:Intracranial Pressure / Q000502:physiology; D008297:Male; D009460:Neurologic Examination; D011183:Postoperative Complications / Q000000981:diagnostic imaging; D011559:Pseudotumor Cerebri / Q000000981:diagnostic imaging / Q000601:surgery*; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome