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  • Craneotomia

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    apfr2691
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    There have been no new medical treatments for cerebral edema and elevated intracranial pressure in more than 80 years. The last decade has seen a renewed interest in the use of decompressive craniectomy. Many questions remain regarding patient selection, timing of surgery, surgical technique, and complications.

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    There have been no new medical treatments for cerebral edema and elevated intracranial pressure in more than 80 years. The last decade has seen a renewed interest in the use of decompressive craniectomy. Many questions remain regarding patient selection, timing of surgery, surgical technique, and complications.

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    63 tayangan1 halaman

    Craneotomia

    Diunggah oleh

    apfr2691
    There have been no new medical treatments for cerebral edema and elevated intracranial pressure in more than 80 years. The last decade has seen a renewed interest in the use of decompressive craniectomy. Many questions remain regarding patient selection, timing of surgery, surgical technique, and complications.

    Hak Cipta:

    Attribution Non-Commercial (BY-NC)
    Unduh sebagai PDF, TXT atau baca online dari Scribd
    Tandai sebagai konten tidak pantas
    dari 1

    (DOI: 10.3171/2009.4.FOCUS.JUNE09.

    INTRO) Neurosurg Focus 26 (6):E1, 2009

    Introduction: Decompressive craniectomy for trauma and


    cerebrovascular disease
    Geoffrey T. Manley, M.D., Ph.D.
    Department of Neurological Surgery, University of California, San Francisco, California

    Elevated intracranial pressure is one of the most common causes of death and disability follow-
    ing severe traumatic brain injury and ischemic stroke. Unfortunately, there have been no new medical
    treatments for cerebral edema and elevated intracranial pressure in more than 80 years. Decompres-
    sive craniectomy may be an appropriate surgical option in the face of elevated intracranial pressure
    that is refractory to medical treatment. When performed correctly, this procedure can reduce intra­
    cranial pressure and prevent cerebral herniation and death. The last decade has seen a renewed inter-
    est in the use of decompressive craniectomy, but many questions remain regarding patient selection,
    timing of surgery, surgical technique, timing of cranioplasty, and complications.

    This issue of Neurosurgical Focus serves to summa- aspects of this procedure. Stiver, importantly, reviews the
    rize some of the latest findings and presents new data in complications of decompressive craniectomy in traumat-
    decompressive craniectomy. In the first article, Danish et ic brain injury, and Aarabi et al. describe the interesting
    al. report their use of meta-analysis to examine outcome phenomena of subdural hygromas following this proce-
    and quality of life in patients after decompressive craniec- dure. The timing of cranioplasty following successful re-
    tomy and their finding of improved outcome compared covery from decompressive craniectomy is controversial.
    to studies published 30 years ago. This is followed by 3 Gooch et al. explore this issue in a single institution with
    articles that describe the successful use of decompres- interesting results. Finally, Cabraja and colleagues report
    sive craniectomy in patients with cerebral ischemia sec- their experience and long-term results using titanium im-
    ondary to cerebrovascular disease. These studies suggest plants for correcting large cranioplasty defects.
    a wider indication for this procedure beyond ischemic 1
    stroke and begin to tackle important questions regarding Together these articles provide timely and much
    the use of this surgical technique in the elderly. From a needed information regarding decompressive craniec-
    technical perspective, Kenning et al., compare a “hinge” tomy for trauma and cerebrovascular disease. I hope that
    craniotomy to the standard decompressive craniectomy. you will find this issue of Neurosurgical Focus interest-
    Their paper highlights the need to study more technical ing and that it will serve to stimulate future studies.

    Neurosurg. Focus / Volume 26 / June 2009 1

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