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Abstract
This is a descriptive study of the possible role of decompressive craniectomy (DC)
in traumatic brain injury (TBI) management in a Nigerian neurosurgical unit; a practice
setting where dedicated neurocritical care service is lacking for the care of TBI.
Over a 12-month period cases of TBI with clinical and radiological evidence of intracranial
hypertension were selected for ‘prophylactic’ DC. Utilization of hospital services
was quantified and outcome at discharge and at follow up was measured with the Glasgow
Outcome Scale Extended. Of the 17 cases, outcome was good in 100% of those with mild
head injury (HI), 66.7% of the moderate HI, and 56% of the severe HI. Utilization
of hospital services, especially the intensive care unit (ICU), increased in proportion
with the severity of the TBI.
Decompressive craniectomy may have a role to play in the developing countries in the
preemptive treatment of posttraumatic raised intracranial pressure. It appears to
hold a great potential in salvaging certain clinically benign cases of HI which usually
have unfavorable outcome in this practice setting.
Keywords
Decompressive craniectomy - traumatic brain injury - developing countries
