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Child's Nervous System

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01-03-2012 | Original Paper

The importance of very early decompressive craniectomy as a prevention to avoid the sudden increase of intracranial pressure in children with severe traumatic brain swelling (retrospective case series)

Authors: András Csókay, John Amaechi Emelifeonwu, László Fügedi, István Valálik, József Láng

Published in: Child's Nervous System | Issue 3/2012

Abstract

Purpose

The purpose of the retrospective case series of eight consecutive patients is to call our attention to the optimal timing of decompressive craniectomy (DC) in children.

Method

We report the outcomes of eight children under the age of 12 with severe head injuries. DC was performed at different intracranial pressure (ICP; 20 and 25 mmHg) levels.

Results

Our results suggest that above 20 mmHg, very fast progression of ICP (within15min) can occur, which may limit the time available to plan and perform DC with a successful patient outcome.

Conclusion

Considering the anamnestic data, it could be useful to perform DC at 20–22 mmHg ICP in young patients in order to prevent the potential of very fast brain swelling if there is no possibility to perform durotomy within 20 min after the onset of raising the ICP. It is especially considerable in poor countries where the emergency route could be less organized because of locations of building and extreme load of the staff. Further controlled trials are necessary to evaluate the indication and standardization of early decompressive craniectomy as a standard preventive therapy in pediatric severe traumatic brain swelling.

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Title: The importance of very early decompressive craniectomy as a prevention to avoid the sudden increase of intracranial pressure in children with severe traumatic brain swelling (retrospective case series)
Authors: András Csókay
John Amaechi Emelifeonwu
László Fügedi
István Valálik
József Láng
Publication date: 01-03-2012
Publisher: Springer-Verlag
Published in: Child's Nervous System / Issue 3/2012
Print ISSN: 0256-7040
Electronic ISSN: 1433-0350
DOI: https://doi.org/10.1007/s00381-011-1661-0

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The importance of very early decompressive craniectomy as a prevention to avoid the sudden increase of intracranial pressure in children with severe traumatic brain swelling (retrospective case series)

Abstract

Purpose

Method

Results

Conclusion

At a glance: The ONWARDS insulin icodec trials

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Abstract

Purpose

Method

Results

Conclusion

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