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PDF | It is unclear whether decompressive craniectomy improves the functional outcome in patients with severe traumatic brain injury and. The Decompressive Craniectomy in Diffuse Traumatic Brain Injury or DECRA trial was the first neurosurgical randomized controlled trail that sought to answer. BACKGROUND It is unclear whether decompressive craniectomy improves the functional outcome in patients with severe traumatic brain injury and refractory.

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Complications of decompressive craniectomy for traumatic brain injury. Guidelines for the Treatment of Head Injury in Adults. Development of the Nervous System. Out of 85 cases, 55 were males, and thirty were females male: From December through Aprilwe randomly assigned adults with severe diffuse traumatic brain injury and intracranial hypertension that was refractory to first-tier therapies to undergo either bifrontotemporoparietal decompressive craniectomy or standard care.

Clinical Pharmacology and Inhury. German Neurosurgical focus Nursing Studies Obstetrics and Gynaecology Gynaecology. Niraj Kumar Choudhary and Rinku Bhargava 1. Early decompressive craniectomy for patients with severe traumatic brain injury and refractory intracranial hypertension–a pilot randomized trial. Although the surgery of DC is relatively simple, it also has significant potential for adverse outcomes, especially considering the emergency nature of the procedures and the chance that younger neurosurgeons are more likely to undertake the surgery.


Decompressive Craniectomy in Diffuse Traumatic Brain Injury: The DECRA Trial – Oxford Medicine

Table 6 Number of patients with different types of surgery performed. Fourth, the barbiturate coma. Other randomized studies have since been on paper, and the result of the DECRA study was released in Therefore, we have to ask ourselves: Intracranial pressure thresholds in severe traumatic brain injury: Acta Neurochir Wien ; The other question is what other indicators need established in order to evaluate DC timing.

Mutsumi NagaiMami Ishikawa World neurosurgery Surgical complications secondary to decompressive craniectomy in patients with a head injury: The trial was conducted over a decade in centers across New Zealand, Saudi Arabia, and Australia, and the results were published in ; patients were randomized to two cohorts, the medical management cohort and the medical management plus Injuy cohort.

N Engl J Med. Respiratory Medicine and Pulmonology. Decompressive craniectomy in the management of traumatic brain injury: It improves braim functional outcome in these patients.

Table 7 Postsurgical complications. N Engl J Med.

Decompressive craniectomy in diffuse traumatic brain injury.

Outcome as per Glasgow outcome score with respect to Glasgow coma scale at the time of admission. Past experience and current developments Andrew I. Surgical decompression for traumatic brain swelling: The study group included 85 patients admitted at Ttaumatic Main Hospital, Jamshedpur with severe diffuse TBI with clinical and radiological evidence of intracranial hypertension who were refractory to first-tier therapies conservative measures to reduce the ICP and underwent DC.


On searching the literature, very few randomized studies relating to this topic exist and with almost no class 1 evidence. Sensory and Motor Systems.

Decompressive craniectomy in diffuse traumatic brain injury. – Semantic Scholar

DC has been a treatment modality since long with a controversial history. It was seen that patients operated early had better surgical outcome in comparison to patients operated late [ Table 8 ]. Oxford University Press; Cite this article as: It was a retrospective case series study from April to March Number of cases with respect to timing of surgery early if done within 24 h and late if done after 24 h.

The primary endpoint was the functional outcomes, measured at 6 months post discharge.

Initial craniectoy release from intracellular stores followed by calcium dysregulation is linked to secondary axotomy following transient axonal stretch injury. The scoring range can be used as a reference indicator for the severity of TBI extremely severe: Mean age of presentation was 36 years.

Child and Adolescent Psychiatry.

In one of the studies, Wilberger et al. This is an open access journal, and articles are distributed under the terms of the Creative Commons Attribution-NonCommercial-ShareAlike 4.