Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress
Clinical Collections
Advances in Alzheimer’s

At a glance: The STEP trials

A round-up of the STEP phase 3 clinical trials evaluating semaglutide for weight loss in people with overweight or obesity.
ADVANCED SEARCH
Log in
Top
Neurocritical Care
Published in: Neurocritical Care 3/2011

01-12-2011 | Practical Pearl

Decompressive Laparotomy for Refractory Intracranial Hypertension After Traumatic Brain Injury

Authors: Jon D. Dorfman, Joseph D. Burns, Deborah M. Green, Christina DeFusco, Suresh Agarwal

Published in: Neurocritical Care | Issue 3/2011

Login to get access

Abstract

Background

Intracranial hypertension is a crucial modifiable risk factor for poor outcome after traumatic brain injury (TBI). Limited evidence suggests that decompressive laparotomy may be an effective treatment for refractory ICH in patients who have elevated intra-abdominal pressure.

Methods

Case report.

Results

We present a multi-trauma patient who sustained severe TBI in a motor vehicle collision. Intracranial pressure (ICP) was initially medically managed but became refractory to standard therapies. Emergent decompressive laparotomy performed in the surgical intensive care unit for abdominal compartment syndrome concomitantly improved the patient’s ICP.

Conclusions

Elevated intra-abdominal pressure can exacerbate intracranial hypertension in patients with TBI. Recognition of this condition and treatment with decompressive laparotomy may be useful in patients with intracranial hypertension refractory to optimal medical therapy.
Literature
1.
Brain Trauma Foundation. Guidelines for the management of severe traumatic brain injury, 3rd edn. J Neurotrauma. 2007;27:S1–106.
2.
Bloomfield GL, Ridings PC, Blocher CR, Marmarou A, Sugerman H. Effects of increased intra-abdominal pressure upon intracranial and cerebral perfusion before and after volume expansion. J Trauma. 1996;40(6):936–43.PubMedCrossRef
3.
Scalea TM, Bochicchio GV, Habashi N, McCunn M, Shih D, McQuillan K, Aarabi B. Increased intra-abdominal, intrathoracic, and intracranial pressure after severe brain injury: multiple compartment syndrome. J Trauma. 2007;62:647–56.PubMedCrossRef
4.
5.
Josephs LG, Este-McDonald JR, Birkett DH, Hirsch EF. Diagnostic laparoscopy increases intracranial pressure. J Trauma. 1994;36:815–8.PubMedCrossRef
6.
Deeren DH, Dits H, Malbrain ML. Correlation between intra-abdominal and intracranial pressure in nontraumatic brain injury patients. Intensive Care Med. 2005;31:1577–81.PubMedCrossRef
7.
Citerio G, Vascotto E, Villa F, Celotti S, Pesenti A. Induced abdominal compartment syndrome increases intracranial pressure in neurotrauma patients: a prospective study. Crit Care Med. 2001;29:1466–71.PubMedCrossRef
8.
Bloomfield GL, Dalton JM, Sugerman HJ, Ridings PC, DeMaria EJ, Bullock R. Treatment of increasing intracranial pressure secondary to the acute abdominal compartment syndrome in a patient with combined abdominal and head trauma. J Trauma. 1995;39:1168–70.PubMedCrossRef
9.
Joseph DK, Dutton RP, Aarabi B, Scalea TM. Decompressive laparotomy to treat intractable intracranial hypertension after traumatic brain injury. J Trauma. 2004;57:687–95.PubMedCrossRef
Metadata
Title
Decompressive Laparotomy for Refractory Intracranial Hypertension After Traumatic Brain Injury
Authors
Jon D. Dorfman
Joseph D. Burns
Deborah M. Green
Christina DeFusco
Suresh Agarwal
Publication date
01-12-2011
Publisher
Humana Press Inc
Published in
Neurocritical Care / Issue 3/2011
Print ISSN: 1541-6933
Electronic ISSN: 1556-0961
DOI
https://doi.org/10.1007/s12028-011-9549-0

Other articles of this Issue 3/2011

Neurocritical Care 3/2011 Go to the issue

Original Article

Prolonged Transcranial Doppler Monitoring After Aneurysmal Subarachnoid Hemorrhage Fails to Adequately Predict Ischemic Risk

Original Article

A Prospective Randomized Study to Evaluate the Antipyretic Effect of the Combination of Acetaminophen and Ibuprofen in Neurological ICU Patients

Original Article

The Genesis of Low Pressure Hydrocephalus

Original Article

Neurologic Examination and Extubation Outcome in the Neurocritical Care Unit

Original Article

The Association Between Proton Pump Inhibitor Use and Outcome After Aneurysmal Subarachnoid Hemorrhage

Original Article

A Comparative Evaluation of Existing Grading Scales in Intracerebral Hemorrhage