J Pediatr Intensive Care 2018; 07(01): 033-038
DOI: 10.1055/s-0037-1603825
Original Article
Georg Thieme Verlag KG Stuttgart · New York

Rescue Decompressive Craniectomy in Children with Severe Traumatic Brain Injury

Dimitrios Rallis
1  Pediatric Intensive Care Unit, “Aghia Sophia” Children's Hospital, Athens, Greece
,
Panagiotis Poulos
1  Pediatric Intensive Care Unit, “Aghia Sophia” Children's Hospital, Athens, Greece
,
Maria Kazantzi
1  Pediatric Intensive Care Unit, “Aghia Sophia” Children's Hospital, Athens, Greece
,
Panagiotis Kalampalikis
1  Pediatric Intensive Care Unit, “Aghia Sophia” Children's Hospital, Athens, Greece
› Author Affiliations
Further Information

Publication History

15 March 2017

10 May 2017

Publication Date:
19 June 2017 (eFirst)

Abstract

Decompressive craniectomy (DC) is considered a rescue therapy in patients with traumatic brain injury (TBI) with increased intracranial pressure (ICP). In this retrospective study, we examined the impact of craniectomy on ICP in children with severe TBI and their neurological outcome. A total of 14 patients were enrolled. Peak ICP was significantly lower (31 ± 2.9 to 19 ± 4.6, p < 0.001) and minimum cerebral perfusion pressure (CPP) higher (41 ± 10.5 to 58 ± 11.4, p < 0.001) postcraniectomy. The survival rate was 71%. However, 57% of our cohort had a poor neurological outcome at 6 months postinjury. In conclusion, although rescue DC was effective in controlling ICP and CPP, the long-term neurological outcome remained poor.