Pediatric traumatic brain injuries treated with decompressive craniectomy.
BACKGROUND
Traumatic brain injury (TBI) occurs in an estimated 80% of all pediatric trauma patients and is the leading cause of death and disability in the pediatric population. Decompressive craniectomy is a procedure used to decrease intracranial pressure by allowing the brain room to swell and therefore increase cerebral perfusion to the brain.


METHODS
This is a retrospective study done at St. Mary's Medical Center/Palm Beach Children's Hospital encompassing a 3 year 7 month period. All the pediatric patients who sustained a TBI and who were treated with a decompressive craniectomy were included. The patients' outcomes were monitored and scored according to the Rancho Los Amigos Score at the time of discharge from the hospital and 6 months postdischarge.


RESULTS
A total of 379 pediatric patients with a diagnosis of TBI were admitted during this time. All these patients were treated according to the severity of their injury. A total of 49 pediatric patients required neurosurgical intervention and 7 of these patients met the criteria for a decompressive craniectomy. All seven patients returned home with favorable outcomes.


CONCLUSIONS
This study supports the current literature that decompressive craniectomy is no longer an intervention used as a last resort but an effective first line treatment to be considered.
Department of Trauma, St. Mary's Medical Center/Palm Beach Children's Hospital, Fl, 33409, USA.
Neil
N
Patel
Michael
M
West
Joanie
J
Wurster
Cassie
C
Tillman
Decompressive craniectomy; ICP monitoring; pediatric intracranial pressure; traumatic brain injury