Inadequate Decompressive Craniectomy Following a Wartime Traumatic Brain Injury - An Illustrative Case of Why Size Matters

Military Medicine
Zachary C JanatpourRandy S Bell

Abstract

Traumatic brain injury has been called the "signature injury" of the wars in Iraq and Afghanistan, and the management of severe and penetrating brain injury has evolved considerably based on the experiences of military neurosurgeons. Current guidelines recommend that decompressive hemicraniectomy be performed with large, frontotemporoparietal bone flaps, but practice patterns vary markedly. The following case is illustrative of potential clinical courses, complications, and efforts to salvage inadequately-sized decompressive craniectomies performed for combat-related severe and penetrating brain injury. The authors follow this with a review of the current literature pertaining to decompressive craniectomy, and finally provide their recommendations for some of the technical nuances of performing decompressive hemicraniectomy after severe or penetrating brain injury.

References

Oct 6, 2006·Journal of Neurotrauma·Thomas S SkoglundBertil Rydenhag
Nov 26, 2009·Critical Care : the Official Journal of the Critical Care Forum·Wusi QiuWeiming Wang
Jun 24, 2010·Neurosurgical Focus·Randy S BellRocco A Armonda
Jun 24, 2010·Neurosurgical Focus·Brian T RagelRocco A Armonda
Mar 26, 2011·The New England Journal of Medicine·D James CooperUNKNOWN Australian and New Zealand Intensive Care Society Clinical Trials Group
Mar 10, 2012·Acta neurochirurgica·Fernanda TagliaferriFranco Servadei
Nov 29, 2012·The Journal of Trauma and Acute Care Surgery·Allison B WeisbrodJames R Dunne
Jul 26, 2013·Lancet Neurology·Jeffrey V RosenfeldGeoffrey S Ling
Dec 3, 2014·World Journal of Surgery·Jeffrey V RosenfeldRocco Armonda
Mar 17, 2016·Surgical Neurology International·George FotakopoulosKostas N Fountas
Sep 8, 2016·The New England Journal of Medicine·Peter J HutchinsonUNKNOWN RESCUEicp Trial Collaborators
Sep 23, 2016·Neurosurgery·Nancy CarneyJamshid Ghajar

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Citations

Nov 30, 2019·Military Medicine·Zachary C JanatpourJonathan E Gilhooly

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