Complications of decompressive craniectomy for traumatic brain injury.

Abstract:

:Decompressive craniectomy is widely used to treat intracranial hypertension following traumatic brain injury (TBI). Two randomized trials are currently underway to further evaluate the effectiveness of decompressive craniectomy for TBI. Complications of this procedure have major ramifications on the risk-benefit balance in decision-making during evaluation of potential surgical candidates. To further evaluate the complications of decompressive craniectomy, a review of the literature was performed following a detailed search of PubMed between 1980 and 2009. The author restricted her study to literature pertaining to decompressive craniectomy for patients with TBI. An understanding of the pathophysiological events that accompany removal of a large piece of skull bone provides a foundation for understanding many of the complications associated with decompressive craniectomy. The author determined that decompressive craniectomy is not a simple, straightforward operation without adverse effects. Rather, numerous complications may arise, and they do so in a sequential fashion at specific time points following surgical decompression. Expansion of contusions, new subdural and epidural hematomas contralateral to the decompressed hemisphere, and external cerebral herniation typify the early perioperative complications of decompressive craniectomy for TBI. Within the 1st week following decompression, CSF circulation derangements manifest commonly as subdural hygromas. Paradoxical herniation following lumbar puncture in the setting of a large skull defect is a rare, potentially fatal complication that can be prevented and treated if recognized early. During the later phases of recovery, patients may develop a new cognitive, neurological, or psychological deficit termed syndrome of the trephined. In the longer term, a persistent vegetative state is the most devastating of outcomes of decompressive craniectomy. The risk of complications following decompressive craniectomy is weighed against the life-threatening circumstances under which this surgery is performed. Ongoing trials will define whether this balance supports surgical decompression as a first-line treatment for TBI.

journal_name

Neurosurg Focus

journal_title

Neurosurgical focus

authors

Stiver SI

doi

10.3171/2009.4.FOCUS0965

subject

Has Abstract

pub_date

2009-06-01 00:00:00

pages

E7

issue

6

issn

1092-0684

journal_volume

26

pub_type

杂志文章,评审
  • Arachnoid cysts: case series and review of the literature.

    abstract:OBJECT:Arachnoid cysts are commonly encountered fluid collections in the central nervous system. Recent advances in neuroimaging have translated into an increased detection of these cysts; that is, diagnoses can be made more frequently at earlier stages. Significant advances have also been made in the surgical manageme...

    journal_title:Neurosurgical focus

    pub_type: 杂志文章,评审

    doi:10.3171/foc.2007.22.2.7

    authors: Pradilla G,Jallo G

    更新日期:2007-02-15 00:00:00

  • Transzygomatic extended middle fossa approach for upper petroclival skull base lesions.

    abstract::Central skull base lesions in the upper retroclival and petroclival regions can be challenging to access because of their location anterior to the brainstem. Several transpetrosal approaches have been developed to access the petroclival junction, including anterior petrosal (anterior petrosectomy), posterior petrosal ...

    journal_title:Neurosurgical focus

    pub_type: 临床试验,杂志文章

    doi:10.3171/FOC.2008.25.12.E5

    authors: Zhao JC,Liu JK

    更新日期:2008-01-01 00:00:00

  • Neurosurgery training in India during the COVID-19 pandemic: straight from the horse's mouth.

    abstract:OBJECTIVE:The COVID-19 pandemic has forced medical professionals throughout the world to adapt to the changing medical scenario. The objective of this survey was to assess the change in neurosurgical training in India following the COVID-19 pandemic. METHODS:Between May 7, 2020, and May 16, 2020, a validated questionn...

    journal_title:Neurosurgical focus

    pub_type: 杂志文章

    doi:10.3171/2020.9.FOCUS20537

    authors: Dash C,Venkataram T,Goyal N,Chaturvedi J,Raheja A,Singla R,Sardhara J,Gupta R

    更新日期:2020-12-01 00:00:00

  • Continuous monitoring of cerebrovascular pressure reactivity in patients with head injury.

    abstract:OBJECT:Cerebrovascular pressure reactivity is the ability of cerebral vessels to respond to changes in transmural pressure. A cerebrovascular pressure reactivity index (PRx) can be determined as the moving correlation coefficient between mean intracranial pressure (ICP) and mean arterial blood pressure. METHODS:The au...

    journal_title:Neurosurgical focus

    pub_type: 杂志文章

    doi:10.3171/FOC.2008.25.10.E2

    authors: Zweifel C,Lavinio A,Steiner LA,Radolovich D,Smielewski P,Timofeev I,Hiler M,Balestreri M,Kirkpatrick PJ,Pickard JD,Hutchinson P,Czosnyka M

    更新日期:2008-10-01 00:00:00

  • Aggressive repeat surgery for focally recurrent primary glioblastoma: outcomes and theoretical framework.

    abstract::OBJECT The relative benefit of repeat surgery for recurrent glioblastoma is unclear, in part due to the very heterogeneous nature of the patient population and the effect of clinician philosophy on the duration and aggressiveness of treatment. The authors sought to investigate the role of time to last recurrence on pa...

    journal_title:Neurosurgical focus

    pub_type: 杂志文章,评审

    doi:10.3171/2014.12.FOCUS14726

    authors: Sughrue ME,Sheean T,Bonney PA,Maurer AJ,Teo C

    更新日期:2015-03-01 00:00:00

  • Idiopathic granulomatous hypophysitis.

    abstract::A case is described of an elderly woman who presented with headaches, hypopituitarism, and visual disturbances and was found to have idiopathic granulomatous hypophysitis, a rare lesion of the pituitary gland. Preoperative magnetic resonance imaging demonstrated a well-circumscribed lesion, which was isointense on bot...

    journal_title:Neurosurgical focus

    pub_type: 杂志文章

    doi:10.3171/foc.1996.1.6.8

    authors: Brisman MH,Morgello S,Silvers A,Klein I,Post KD

    更新日期:1996-07-15 00:00:00

  • Management of surgical clinoidal meningiomas.

    abstract:OBJECT:Clinoidal meningiomas remain a major neurosurgical challenge. Surgery-related outcome has been less than desirable in the past, and little attention has been directed toward improving visual deficits. The authors advocate a skull base technique for the removal of these difficult tumors and describe its advantage...

    journal_title:Neurosurgical focus

    pub_type: 杂志文章

    doi:10.3171/foc.2003.14.6.5

    authors: Tobias S,Kim CH,Kosmorsky G,Lee JH

    更新日期:2003-06-15 00:00:00

  • Pediatric sports-related traumatic brain injury in United States trauma centers.

    abstract::OBJECTIVE Traumatic brain injury (TBI) in children is a significant public health concern estimated to result in over 500,000 emergency department (ED) visits and more than 60,000 hospitalizations in the United States annually. Sports activities are one important mechanism leading to pediatric TBI. In this study, the ...

    journal_title:Neurosurgical focus

    pub_type: 杂志文章

    doi:10.3171/2016.1.FOCUS15612

    authors: Yue JK,Winkler EA,Burke JF,Chan AK,Dhall SS,Berger MS,Manley GT,Tarapore PE

    更新日期:2016-04-01 00:00:00

  • Integration of functional neuronavigation and intraoperative MRI in surgery for drug-resistant extratemporal epilepsy close to eloquent brain areas.

    abstract:OBJECT:The authors performed a retrospective study to assess the impact of functional neuronavigation and intraoperative MRI (iMRI) on surgery of extratemporal epileptogenic lesions on postsurgical morbidity and seizure control. METHODS:Twenty-five patients (14 females and 11 males) underwent extratemporal resections ...

    journal_title:Neurosurgical focus

    pub_type: 杂志文章

    doi:10.3171/2013.2.FOCUS12397

    authors: Sommer B,Grummich P,Coras R,Kasper BS,Blumcke I,Hamer HM,Stefan H,Buchfelder M,Roessler K

    更新日期:2013-04-01 00:00:00

  • Clipping of a partially thrombosed giant VA aneurysm.

    abstract::Microsurgical aspects of clipping of a giant partially thrombosed VA aneurysm in a 57-year-old female are presented and explained in the form of a short video. The presentation includes preparation of the VA, PICA and perforating arteries, the clipping of the aneurysm itself as well as the reduction of the aneurysm ma...

    journal_title:Neurosurgical focus

    pub_type: 杂志文章

    doi:10.3171/2015.V1.FOCUS14598

    authors: von Schilling A,Spetzger U

    更新日期:2015-01-01 00:00:00

  • Intramedullary spinal cysticercosis. Case report and review of the literature.

    abstract::Cysticercosis is the most common parasitic infection of the central nervous system. It infrequently affects the spine, but when it does, it can present with symptoms similar to other more common spinal diseases. The authors present a case of isolated intramedullary cysticercosis of the cervical spine and review the li...

    journal_title:Neurosurgical focus

    pub_type: 杂志文章,评审

    doi:10.3171/foc.2002.12.6.11

    authors: Sheehan JP,Sheehan J,Lopes MB,Jane JA Sr

    更新日期:2002-06-15 00:00:00

  • Hypothalamic hamartomas. Part 1. Clinical, neuroimaging, and neurophysiological characteristics.

    abstract::Hypothalamic hamartomas are uncommon but well-recognized developmental malformations that are classically associated with gelastic seizures and other refractory seizure types. The clinical course is often progressive and, in addition to the catastrophic epileptic syndrome, patients commonly exhibit debilitating cognit...

    journal_title:Neurosurgical focus

    pub_type: 杂志文章,评审

    doi:10.3171/2013.3.FOCUS1355

    authors: Mittal S,Mittal M,Montes JL,Farmer JP,Andermann F

    更新日期:2013-06-01 00:00:00

  • Arteriovenous malformation presenting with epilepsy: a multimodal approach to diagnosis and treatment.

    abstract::Arteriovenous malformation (AVM) presenting with epilepsy significantly impacts patient quality of life, and it should be considered very much a seizure disorder. Although hemorrhage prevention is the primary treatment aim of AVM surgery, seizure control should also be at the forefront of therapeutic management. Sever...

    journal_title:Neurosurgical focus

    pub_type: 杂志文章

    doi:10.3171/2020.1.FOCUS19899

    authors: Soldozy S,Norat P,Yağmurlu K,Sokolowski JD,Sharifi KA,Tvrdik P,Park MS,Kalani MYS

    更新日期:2020-04-01 00:00:00

  • Atypical tumors of the facial nerve: case series and review of the literature.

    abstract:OBJECT:The authors present a series of 4 patients with rare facial nerve tumors. The relevant literature is reviewed and is discussed regarding diagnostic features, the role of operative management, and surgical approach. METHODS:A retrospective chart review was conducted for patients with tumors of the facial nerve t...

    journal_title:Neurosurgical focus

    pub_type: 杂志文章,评审

    doi:10.3171/2013.1.FOCUS12380

    authors: Ross L,Drazin D,Eboli P,Lekovic GP

    更新日期:2013-03-01 00:00:00

  • "Picture-in-picture" endoscopic images in the microscope.

    abstract::The authors describe a new piece of equipment that enables simultaneous monitoring of the endoscopic image and unilateral microscopic image; that is, "picture-in-picture" images for endoscope-assisted microsurgery. The system is simple and purely optical, consisting of light-weight semi-rigid fibers and a special adap...

    journal_title:Neurosurgical focus

    pub_type: 杂志文章

    doi:10.3171/foc.1999.6.4.13

    authors: Seki Y,Umezu H,Usui M,Tsumanuma T,Nakatate K

    更新日期:1999-04-15 00:00:00

  • Motor-evoked potential monitoring for intramedullary spinal cord tumor surgery: correlation of clinical and neurophysiological data in a series of 100 consecutive procedures.

    abstract::Resection of intramedullary spinal cord tumors carries a high risk for surgical damage to the motor pathways. This surgery is therefore optimal for testing the performance of intraoperative motor evoked potential (MEP) monitoring. This report attempts to provide evidence for the accurate representation of patients' pr...

    journal_title:Neurosurgical focus

    pub_type: 杂志文章

    doi:10.3171/foc.1998.4.5.4

    authors: Kothbauer KF,Deletis V,Epstein FJ

    更新日期:1998-05-15 00:00:00

  • Quality of life following acoustic neuroma surgery.

    abstract::In the treatment of acoustic neuroma, operative results have improved greatly during recent years, with high rates of functional cranial nerve preservation. Because of this, it has become more important to consider issues of patient satisfaction and quality of life (QOL) following treatment for these lesions. The auth...

    journal_title:Neurosurgical focus

    pub_type: 杂志文章

    doi:

    authors: Schwartz MS,Riddle SA,Delashaw JB Jr,Horgan MA,Kellogg JX,McMenomey SO

    更新日期:1998-09-15 00:00:00

  • Robotic versus fluoroscopy-guided pedicle screw insertion for metastatic spinal disease: a matched-cohort comparison.

    abstract::OBJECTIVE Robot-guided pedicle screw placement is an established technique for the placement of pedicle screws. However, most studies have focused on degenerative disease. In this paper, the authors focus on metastatic spinal disease, which is associated with osteolysis. The associated lack of dense bone may potential...

    journal_title:Neurosurgical focus

    pub_type: 杂志文章

    doi:10.3171/2017.3.FOCUS1710

    authors: Solomiichuk V,Fleischhammer J,Molliqaj G,Warda J,Alaid A,von Eckardstein K,Schaller K,Tessitore E,Rohde V,Schatlo B

    更新日期:2017-05-01 00:00:00

  • Surgical approaches for resection of vestibular schwannomas: translabyrinthine, retrosigmoid, and middle fossa approaches.

    abstract::Surgical removal remains one of the key treatment modalities for vestibular schwannomas. A team approach between a neurotologist and a neurosurgeon offers the patient the expertise of both specialties and maximizes the chances for an optimal outcome. Vestibular schwannomas can typically be resected through 1 of 3 main...

    journal_title:Neurosurgical focus

    pub_type: 杂志文章,评审

    doi:10.3171/2012.6.FOCUS12190

    authors: Chamoun R,MacDonald J,Shelton C,Couldwell WT

    更新日期:2012-09-01 00:00:00

  • Length of hospital stay after craniotomy for tumor: a National Surgical Quality Improvement Program analysis.

    abstract::OBJECT Although the length of hospital stay is often used as a measure of quality of care, data evaluating the predictors of extended hospital stay after craniotomy for tumor are limited. The goals of this study were to use multivariate regression to examine which preoperative characteristics and postoperative complic...

    journal_title:Neurosurgical focus

    pub_type: 杂志文章

    doi:10.3171/2015.10.FOCUS15386

    authors: Dasenbrock HH,Liu KX,Devine CA,Chavakula V,Smith TR,Gormley WB,Dunn IF

    更新日期:2015-12-01 00:00:00

  • Stereotactic robot-assisted MRI-guided laser thermal ablation of radiation necrosis in the posterior cranial fossa: technical note.

    abstract::Laser interstitial thermal therapy (LITT) is a minimally invasive procedure used to treat a variety of intracranial lesions. Utilization of robotic assistance with stereotactic procedures has gained attention due to potential for advantages over conventional techniques. The authors report the first case in which robot...

    journal_title:Neurosurgical focus

    pub_type: 杂志文章

    doi:10.3171/2016.4.FOCUS1622

    authors: Chan AY,Tran DK,Gill AS,Hsu FP,Vadera S

    更新日期:2016-10-01 00:00:00

  • Curative Onyx embolization of tentorial dural arteriovenous fistulas.

    abstract:OBJECT:The authors conducted a study to review their experience with tentorial dural arteriovenous fistulas (DAVFs) treated with transarterial endovascular embolization in which Onyx was used. METHODS:The authors reviewed prospectively collected data in 9 patients with tentorial DAVFs treated with Onyx embolization be...

    journal_title:Neurosurgical focus

    pub_type: 杂志文章

    doi:10.3171/2011.12.FOCUS11323

    authors: Puffer RC,Daniels DJ,Kallmes DF,Cloft HJ,Lanzino G

    更新日期:2012-05-01 00:00:00

  • Contemporary health care economics: an overview.

    abstract::Economic evaluations provide a decision-making framework in which outcomes (benefits) and costs are assessed for various alternative options. Although the interest in complete and partial economic evaluations has increased over the past 2 decades, the quality of studies has been marginal due to methodological challeng...

    journal_title:Neurosurgical focus

    pub_type: 杂志文章,评审

    doi:10.3171/2014.8.FOCUS14455

    authors: McLaughlin N,Ong MK,Tabbush V,Hagigi F,Martin NA

    更新日期:2014-11-01 00:00:00

  • Endovascular strategies for carotid cavernous and intracerebral dural arteriovenous fistulas.

    abstract::Interventional neuroradiology is a less invasive modality than open neurosurgery for the treatment of a wide range of neurovascular disorders. Refinements in technique and improvements in the design of microcatheters, guide wires, and embolic materials have yielded superior clinical outcomes and provided an impetus to...

    journal_title:Neurosurgical focus

    pub_type: 杂志文章,评审

    doi:10.3171/foc.2003.15.4.7

    authors: Ng PP,Higashida RT,Cullen S,Malek R,Halbach VV,Dowd CF

    更新日期:2003-10-15 00:00:00

  • Prevalence of cervical spinal injury in trauma.

    abstract:OBJECT:Diagnosis of cervical spinal injury (CSI) is an essential aspect of the trauma evaluation. This task is especially difficult in patients who are not clinically able to be evaluated (unevaluable) because of distracting painful injuries, intoxication, or concomitant head injury. For this population, the appropriat...

    journal_title:Neurosurgical focus

    pub_type: 杂志文章,评审

    doi:10.3171/FOC.2008.25.11.E10

    authors: Milby AH,Halpern CH,Guo W,Stein SC

    更新日期:2008-01-01 00:00:00

  • Carotid endarterectomy: current indications for surgery.

    abstract::The study of carotid artery occlusive disease interventions can be divided clinically into the treatment of asymptomatic and symptomatic diseases. Clinical trials that have studied or are currently studying asymptomatic disease include: the Carotid Artery Stenosis with Asymptomatic Narrowing Operation Versus Aspirin s...

    journal_title:Neurosurgical focus

    pub_type: 杂志文章

    doi:

    authors: Brennan JJ,Loftus CM

    更新日期:1998-12-15 00:00:00

  • Delayed central nervous system superficial siderosis following brachial plexus avulsion injury. Report of three cases.

    abstract::Chronic subarachnoid hemorrhage may cause deposition of hemosiderin on the leptomeninges and subpial layers of the neuraxis, leading to superficial siderosis (SS). The symptoms and signs of SS are progressive and fatal. Exploration of potential sites responsible for intrathecal bleeding and subsequent hemosiderin depo...

    journal_title:Neurosurgical focus

    pub_type: 杂志文章,评审

    doi:10.3171/foc.2004.16.5.11

    authors: Cohen-Gadol AA,Krauss WE,Spinner RJ

    更新日期:2004-05-15 00:00:00

  • Biomechanics of the posterior lumbar articulating elements.

    abstract::The clinical success of lumbar spinal fusion varies considerably, depending on techniques and indications. Although spinal fusion generally helps to eliminate certain types of pain, it may also decrease function by limiting patient mobility. Furthermore, spinal fusion may increase stresses on adjacent nonfused motion ...

    journal_title:Neurosurgical focus

    pub_type: 杂志文章,评审

    doi:10.3171/foc.2007.22.1.1

    authors: Serhan HA,Varnavas G,Dooris AP,Patwadhan A,Tzermiadianos M

    更新日期:2007-01-15 00:00:00

  • A stepwise illustration of the retrosigmoid approach for resection of a cerebellopontine meningioma.

    abstract::The retrosigmoid approach is a work-horse approach to the cerebellopontine angle (CPA), providing access from the foremen magnum to the tentorium. Indications for this approach are variable such as resection of meningiomas, acoustic neuromas and epidermoid tumors, treatment of vascular lesions of vertebrobasilar syste...

    journal_title:Neurosurgical focus

    pub_type: 杂志文章

    doi:10.3171/2014.V1.FOCUS13445

    authors: Cıkla U,Kujoth GC,Başkaya MK

    更新日期:2014-01-01 00:00:00

  • Quality Outcomes Database Spine Care Project 2012-2020: milestones achieved in a collaborative North American outcomes registry to advance value-based spine care and evolution to the American Spine Registry.

    abstract::The Quality Outcomes Database (QOD), formerly known as the National Neurosurgery Quality Outcomes Database (N2QOD), was established by the NeuroPoint Alliance (NPA) in collaboration with relevant national stakeholders and experts. The overarching goal of this project was to develop a centralized, nationally coordinate...

    journal_title:Neurosurgical focus

    pub_type: 杂志文章

    doi:10.3171/2020.2.FOCUS207

    authors: Asher AL,Knightly J,Mummaneni PV,Alvi MA,McGirt MJ,Yolcu YU,Chan AK,Glassman SD,Foley KT,Slotkin JR,Potts EA,Shaffrey ME,Shaffrey CI,Haid RW,Fu KM,Wang MY,Park P,Bisson EF,Harbaugh RE,Bydon M

    更新日期:2020-05-01 00:00:00