Top

Acta Neurochirurgica

Published in:

01-05-2019 | Intracranial Hypertension | How I Do it - Neurosurgery general

How I do it: supra-tentorial unilateral decompressive craniectomy

Authors: Nicolas Desse, Nathan Beucler, Arnaud Dagain

Published in: Acta Neurochirurgica | Issue 5/2019

Abstract

Background

Decompressive craniectomy is a surgical way to treat intracranial hypertension, by removing a large flap of skull bone.

Method

We report the case of a 48 years old right-handed man presenting an acute ischaemic stroke of all the right sylvian artery area, with rapid clinic deterioration then coma. Severe intracranial hypertension was confirmed by transcranial Doppler. In emergency, we decided to perform a right-side decompressive craniectomy.

Conclusion

Six months later, he is in rehabilitation with “only” a left hemiplegia and a very good relational life. His modified Rankin score is 3. Decompressive craniectomy saved this patient’s life, that is why we think this surgical technique must be explained and mastered.

Available only for authorised users

Flint AC, Manley GT, Gean AD, Hemphill JC, Rosenthal G (2008) Post-operative expansion of hemorrhagic contusions after unilateral decompressive hemicraniectomy in severe traumatic brain injury. J Neurotrauma 25(5):503–512CrossRefPubMed

Hutchinson PJ, Kolias AG, Timofeev IS, Corteen EA, Czosnyka M, Timothy J et al (2016) Trial of decompressive craniectomy for traumatic intracranial hypertension. N Engl J Med 375(12):1119–1130CrossRef

Kakar V, Nagaria J, John Kirkpatrick P (2009) The current status of decompressive craniectomy. Br J Neurosurg 23(2):147–157CrossRefPubMed

Kemmling A, Duning T, Lemcke L, Niederstadt T, Minnerup J, Wersching H et al (2010) Case report of MR perfusion imaging in sinking skin flap syndrome: growing evidence for hemodynamic impairment. BMC Neurol 10(1):80CrossRefPubMedPubMedCentral

Polin RS, Shaffrey ME, Bogaev CA, Tisdale N, Germanson T, Bocchicchio B et al (1997) Decompressive bifrontal craniectomy in the treatment of severe refractory posttraumatic cerebral edema. Neurosurgery. 41(1):84 92–discussion 92–4CrossRefPubMed

Sedney CL, Julien T, Manon J, Wilson A (2014) The effect of craniectomy size on mortality, outcome, and complications after decompressive craniectomy at a rural trauma center. J Neurosci Rural Pract 5(3):212–217CrossRefPubMedPubMedCentral

Stiver SI (2009) Complications of decompressive craniectomy for traumatic brain injury. Neurosurg Focus 26(6):E7CrossRefPubMed

Tagliaferri F, Zani G, Iaccarino C, Ferro S, Ridolfi L, Basaglia N et al (2012) Decompressive craniectomies, facts and fiction: a retrospective analysis of 526 cases. Acta Neurochir 154(5):919–926CrossRefPubMed

Timofeev I, Santarius T, Kolias AG, Hutchinson PJA (2012) Decompressive craniectomy - operative technique and perioperative care. Adv Tech Stand Neurosurg 38:115–136CrossRefPubMed

10.

Vahedi K, Hofmeijer J, Juettler E, Vicaut E, George B, Algra A et al (2007) Early decompressive surgery in malignant infarction of the middle cerebral artery: a pooled analysis of three randomised controlled trials. Lancet Neurol 6(3):215–222CrossRefPubMed

Title: How I do it: supra-tentorial unilateral decompressive craniectomy
Authors: Nicolas Desse
Nathan Beucler
Arnaud Dagain
Publication date: 01-05-2019
Publisher: Springer Vienna
Keywords: Intracranial Hypertension
Hypertension
Published in: Acta Neurochirurgica / Issue 5/2019
Print ISSN: 0001-6268
Electronic ISSN: 0942-0940
DOI: https://doi.org/10.1007/s00701-019-03880-x

Keynote webinar | Spotlight on medication adherence

Springer Medicine

How I do it: supra-tentorial unilateral decompressive craniectomy

Abstract

Background

Method

Conclusion

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Background

Method

Conclusion

Please log in to get access to this content

Other articles of this Issue 5/2019

Combined supra-infrasellar approach to pituitary macroadenoma with oculomotor cistern extension: surgical strategy and experience

Diffusion-weighted magnetic resonance imaging for detection of postoperative intracranial pyogenic abscesses in neurosurgery

ioCT-guided percutaneous radiofrequency ablation for trigeminal neuralgia: how I do it

The significance of intra-abdominal pressure in neurosurgery and neurological diseases: a narrative review and a conceptual proposal

Fluorescence imaging of meningioma cells with somatostatin receptor ligands: an in vitro study

Response to “Going beyond scoring systems for cavernous sinus involvement in trans-sphenoidal pituitary surgery”