Semin Neurol 2016; 36(06): 508-519
DOI: 10.1055/s-0036-1592170
Review Article
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Decompressive Craniectomy in Neurocritical Care

Erik G. Hayman
1   Departments of Neurosurgery, University of Maryland School of Medicine, Baltimore, Maryland
,
David B. Kurland
1   Departments of Neurosurgery, University of Maryland School of Medicine, Baltimore, Maryland
,
Zachary Grunwald
2   Department of Neurology, Yale University School of Medicine, New Haven, Connecticut
,
Sebastian Urday
2   Department of Neurology, Yale University School of Medicine, New Haven, Connecticut
,
Kevin N. Sheth
2   Department of Neurology, Yale University School of Medicine, New Haven, Connecticut
,
J. Marc Simard
1   Departments of Neurosurgery, University of Maryland School of Medicine, Baltimore, Maryland
3   Department of Pathology, University of Maryland School of Medicine, Baltimore, Maryland
4   Department of Physiology, University of Maryland School of Medicine, Baltimore, Maryland
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Publikationsverlauf

Publikationsdatum:
01. Dezember 2016 (online)

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Abstract

Neurosurgeons increasingly use decompressive craniectomy (DC) in neurocritical care. In this review, the authors summarize the topic of DC for the neurointensivist. Following a brief overview of the procedure, the major indications for the procedure are described. This includes a review of the literature regarding well-established indications, such as infarction and traumatic brain injury, as well as lesser known indications, including intracerebral hemorrhage, ruptured cerebrovascular malformations, sinus thrombosis, and infection. Complications unique to DC, specifically syndrome of the trephined, hygroma, and hydrocephalus, also are reviewed with a discussion of their management, both in the immediate and the postoperative period.