Late decompressive craniectomy as rescue treatment for refractory high intracranial pressure in children and adults.
The purpose of this study was to determine the prognosis of children and adults in whom decompressive craniectomy (DC) was used as a rescue treatment to lower refractory high intracranial pressures if maximal conservative therapies failed.Data of DC patients were retrospectively reviewed. Three-month and 1-year outcomes were evaluated (modified Rankin Score). Twenty-one patients were studied, 8 children and 13 adults. Eleven suffered from traumatic brain swelling, in 10 the primary pathological condition was intracranial hemorrhage, arteriovenous malformation bleeding or subarachnoid hemorrhage. All 13 survivors (62%) had a favorable outcome after 1 year (mRS≤3), 8 (38%) lacked any disabilities at all. Therefore, decompressive craniectomy offers a chance for a favorable outcome in uncontrollable ICP.
Department of Anesthesiology, Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands. c.vandermeer@anes.umcn.nl
Catrien
C
van der Meer
Erik
E
van Lindert
Ronald
R
Petru
D000293:Adolescent; D000328:Adult; D000367:Age Factors; D001794:Blood Pressure / Q000502:physiology; D001929:Brain Edema / Q000209:etiology / Q000601:surgery; D002648:Child; D056424:Decompressive Craniectomy / Q000379:methods*; D005260:Female; D006801:Humans; D019586:Intracranial Hypertension / Q000150:complications / Q000601:surgery*; D007427:Intracranial Pressure / Q000502:physiology; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D016896:Treatment Outcome